What is it?

Osteopathic Medicine, also known as Osteopathy, is a distinctive form of medical care. Founded on the philosophy that all body systems are interrelated and dependant upon one another for good health. Although this type of medical care is widely known and regulated by different bodies nationally and abroad, many consider this practice alternative given its holistic approach to disease.

Doctor of Osteopathic Medicine, or DOs, are in fact fully licensed physicians who practice in all areas of medicine. Emphasizing a whole-person approach to treatment and care, DOs practice in all medical specialties. During medical school, they receive special training in the musculoskeletal system, your body’s interconnected system of nerves, muscles, and bones. By combining this knowledge with the latest advances in medical technology, they offer patients the most comprehensive care available in medicine. Osteopathic physicians focus on prevention, tuning into how a patient’s lifestyle and environment can impact their wellbeing. DOs strive to help you be truly healthy in mind, body, and spirit – not just free of symptoms.

Core philosophy

The Tenets of Osteopathic Medicine express the underlying philosophy of osteopathic medicine. These tenets were officially approved by the AOA House of Delegates as policy. They are as follows:

The body is a unit; the person is a unit of body, mind and spirit

The first of the major principles of osteopathic medicine is that the human body is a unit, an integrated organism in which no part functions independently. This regulation, coordination and integration of the body through multiple biological systems are often referred to as the principle of body unity.

According to this principle, abnormalities in the structure or function of one part of the body may unfavorably influence other parts, and eventually, the body as a whole. Thus, the body is viewed as an interrelated group of organ systems, each one dependent on the others. Each one compensates along with the other in order to meet the demands of the environments of the body. Despite the popularity of the term “holistic”, there is a tendency among physicians to isolate illness to a specific organ/system. The osteopathic physician, however, recognizes that when the body is sick, it is sick all over.

The body is capable of self-regulation, self-healing and health maintenance

The second major principle of osteopathic medicine is that the body has an inherent capacity to maintain its own health and to heal itself. By extension, this principle implies that there must be adequate circulation to and from all tissues of the body, and there must be proper nervous system function in order to coordinate the actions of all of the body’s organs and systems.

The job of the osteopathic physician is to help the body utilize its own self-healing mechanisms to overcome disease and maintain health. Osteopathic physicians recognize that the body constantly attempts to resist or overcome the various stresses to which it is exposed. The degree to which the body is successful in these attempts determines its state of health.

Structure and function are reciprocally interrelated

The third basic osteopathic principle is that structure and function are interrelated. There is special emphasis on the role of the musculoskeletal system in health and disease. The interrelationship between structure and function is, in fact, one of the most unique aspects of osteopathic medicine.

A simple analogy of this principle is the functioning of a machine. The parts of the machine have to be properly assembled for the whole machine to work properly. If the machine is not functioning properly, the parts will need adjustment until it does. The musculoskeletal system (bones, muscles, ligaments and connective tissues) is the largest collective system of the body, making up 60% or more of the body’s mass. This is the reason why osteopathic physicians focus on manipulative methods to remove structural abnormalities to alleviate the patient’s illness.

Rational treatment approach

The fourth basic principle of osteopathic medicine is that rational treatment is based upon the integration of the first three principles into the total care of the patient. Therefore, treatment is based on the principles of body unity, self-regulatory and self-healing mechanisms, the somatic component of the disease, the interrelationship between structure and function, and the appropriate use of manipulative treatment.

In practical terms, the osteopathic physicians organize these principles around frameworks. According to Western University of Health Sciences, osteopaths can use the following models:

  • The Mechanical Model: dealing with factors that alter posture, motion, and gait. These factors include altered joint relationships, muscle imbalances, and abnormal fascial tensions.
  • The Neurologic Model: dealing with the effects of facilitated spinal cord segments and sustained symphaticotonia.
  • The Respiratory-Circulatory Model: dealing with respiratory mechanics which may predispose to congestive changes, decreased lymphatic flow, venous return and edema formation.
  • The Metabolic-Nutritional Model: dealing with dietary deficiencies and excesses, food allergies, the effect on toxins and any other factors that may affect the self-regulatory and self-healing mechanisms of the body.
  • The Biopsychosocial Model: dealing with psychological and social components like the patient’s spiritual outlook, social support system, ability to cope with stress and ability to make healthy lifestyle choices.


Andrew Taylor Still

American physician Andrew Taylor Still first conceived and developed osteopathy in an effort to improve the practice of medicine. As a 19th central medical doctor, Dr. Still became increasingly dissatisfied with the prevailing approach to health care in his profession.

He witnessed firsthand the failure of common medical treatments as a Civil War hospital steward and surgeon. When three of Still’s children, his wife, and an adopted child died from spinal meningitis in 1964, he formed a grim determination to pioneer a more effective, holistic approach to healing. During the years 1865 to 1870 Still gradually reestablished his medical practice relying on a system of manipulation and spinal reflexes that he devised to treat all types of conditions. Despite his therapeutic successes, he was, for many, as a medical heretic, a grave robber, and a “crazy crank”. His methods obtained results that were not otherwise explainable, so many Methodist preachers viewed his practice as the work of the devil.

Dr. Still established the American School of Osteopathy in 1892, and the first 18 graduates matriculated in 1894. True to the basics of osteopathy, classwork focused primarily on the form and function of human anatomy. Many of the principles and practices of conventional medicine are in sync with those of osteopathy. The primary difference between the two disciplines is the practitioner’s perception of health and disease. Medicine traditionally views disease as an aggressor that must be vanquished with drugs or surgery, leaving the patient healthy once again. In contrast, osteopaths regard illness as the result of weakened bodily systems and direct their treatments toward the rejuvenation of the body and the restoration of its optimal function. By the late 1890’s, his school, infirmary, and new surgical hospital were increasingly successful both academically and financially.

Osteopathy after Still

Today, in all fifty states osteopathic licensure is equivalent to that of conventional physicians. Organized osteopathy had to battle the powerful American Medical Association which sought to maintain its monopolistic hold on American Medicine. It wasn’t until the Vietnam War that osteopaths could serve their country as physicians. Today there are 26 osteopathic colleges, some of which state-supported schools where osteopathic and allopathic students share faculty and facilities.

As we all know, many around the world are seeking out alternatives to the impersonal approach taking by conventional medicine. Interest in natural methods such as homeopathy, acupuncture, and herbal medicine is enjoying a universal renewal and Osteopathy stands in the center of this renaissance. For instance, Daniel David Palmer, a magnetic healer from Iowa came to Kirksville in 1893 for a consultation with Still. After several treatments, he returned home and two years later announced his discovery of chiropractic. In recent years, Cranial-Sacral Therapy arrived on the scene. This is merely the rewording of Osteopathy and includes insights derived from the work of one of Still’s most brilliant students.

As of now, 32+ countries have granted osteopathic physicians unlimited practices privileges with an additional 9 countries granting privileges limited to manipulation.

Benefits and uses

Osteopathy is a natural medicine with the intention of restoring the normal functioning of the body by treating the causes of pain and imbalances. An osteopath will use their hands to treat your body using a mixture of gentle techniques. They can include:

  • Soft tissue stretching and cross fiber massage therapy.
  • Sustained trigger point pressure
  • Gentle joint manipulation
  • Mobilization techniques
  • Muscle Energy Techniques (MET)
  • Biodynamic Craniosacral Therapy
  • Lymphatic drainage techniques

Articulating the benefits of osteopathy is difficult as the practice is broad. It is akin to articulating the benefits of seeing a physician. However, in general terms, the benefits of seeing an osteopathic physician are:

Alleviating pain

Osteopaths treat the pain you experience in a way that considers you as a person as your body as a whole. Osteopathic treatment can be effective in reducing and alleviating pain in a number of different areas including back pain, neck pain, headaches and ankle sprains. Osteopathy can:

  • Remove the underlying cause of pain
  • Reduce pain and stiffness in muscles and joints
  • Increase the range of minions in the joints
  • Treat spinal problems resulting from poor posture
  • Relieve chronic pain through non-invasive treatment
  • Decrease the stress of the joints
  • Reduce tension in the body

Reducing discomfort from chronic illnesses

Your osteopath is able to provide treatments that provide relief from the symptoms of many chronic illnesses. Common examples include asthma, arthritis, and irritable bowel syndrome (IBS).

Preventing injury

Osteopaths can help prevent a reoccurrence of an injury or acute condition or the development of an injury due to lifestyle factors. In particular, osteopathy can:

  • Reduce scars and adhesions
  • Treat trauma resulting from accidents
  • Encourage the body to heal itself


By giving you time to be aware of yourself and your body, osteopathy can be very relaxing. It can also reduce stress levels by increasing the efficiency of your body’s systems like blood flow, nerve supply, and immune system. Osteopathy can:

  • Increase circulation
  • Reduce blood pressure

Who practices it

Osteopaths are licensed doctors

Osteopathic medicine is the fastest-growing segment of healthcare that many people have never heard of. In 2017, the number of practicing osteopaths in the United States exceeded 100,000, representing a 65% increase from 1990.

Osteopaths are licensed doctors, as are MDs. In fact, osteopaths make up roughly 10% of the doctors in the US (expected to double by 2030). One of the biggest differences between allopathic doctors (MDs) and doctors of osteopathy (DOs) has to do with education.

  • MDs go to medical school to earn a Doctor of Medicine (MD) degree.
  • DOs go to medical school to earn a Doctor of Osteopathic Medicine (DO) degree.

Education requirements

DOs must earn a bachelor’s degree, complete medical school, finish residency training, and pass their licensing exams. This takes a minimum of 12 years. The first two years in osteopathic medical school will be spent in the classroom doing coursework in anatomy, physiology, biochemistry, pathology, family medicine, pediatrics, osteopathic principles and osteopathic practices. The next two years will be spent doing clinical rotations. The aspiring doctor will treat patients in departments like the ER, internal medicine, neurology, and radiology under supervision in hospitals and other clinical settings.

After medical school comes the three-to-eight-year residency, also similar to allopathic medicine. Most osteopathic residency admissions committees prefer that candidates take the Comprehensive Osteopathic Medical Licensure Exam (COMLEX). Osteopaths need to complete one year of general internship before moving on to a residency, but after that DO graduates can learn any specialty (including surgery) and can use the National Resident Matching Program just like MDs. Most DOs, however, end up choosing primary care medicine as their focus.

Each state has its own rules about license requirements for osteopathic doctors, but generally, to get a license to practice, DOs must graduate from an accredited osteopathic college, complete a specialty residency and pass the COMLEX exam. Board certification generally isn’t necessary, but further accreditation or education for an osteopath may be required depending on the state. Osteopaths can become board certified in their specialty by taking qualifying exams given by the AOA in 18 different specialty areas plus additional subspecialties once they’ve finished their residencies.

What to expect

If you’ve even been to a Primary Care Physician, the experience with a DO will have a number of similarities. The main difference involves the use of OMT (Osteopathic Manipulative Treatment), which is the so-called osteopathic “hands-on method”.

The Initial Intake

First, the doctor will ask for a complete medical history, including specific questions about the history of the symptoms under question, episodes, and prior treatments. There might be an examination phase where you might be provided a gown and where the DO will ask you to make simple movements and stretches to observe your posture and mobility.

The exams

It is not uncommon for the DO to request blood samples and additional exams in order to customize the treatment. In the event that the DO identifies a condition they can’t address, they will refer you to the proper specialist. It is not uncommon for the DO to suggest alternative methods like acupuncture, energy work, etc.

The Assessment

The osteopath will examine the health of the joints, tissues, and ligaments using their hands. They have a highly developed sense of touch called palpation. The osteopathic physician will propose a treatment plan to meet the patient’s needs. This can include a number of sessions and at-home exercises. This number may change depending on the patient’s response to the treatment.

The treatment

There are numerous techniques that the DO can utilize during the treatment. During treatment, the DO will assess progress on your condition. The treatment may vary depending on how well the patient is responding to the treatment.

Interesting facts

Osteopathic medicine is as broad as allopathic medicine. However, it doesn’t share the same popularity. Here are some interesting facts about this relatively new form of medicine:

  • The word “osteopath” comes from the Greek world “osteo” which means “structure”.
  • During an osteopathy session, the treatment can range from applying subtle to strong pressure. This happens mostly in places other than where the patient feels the problem. The causes of the symptoms are often located in other parts of the body than where the symptoms occur.
  • Presidents George W. Bush and Joe Biden employ osteopaths as their primary doctors.
  • After an osteopath treatment, the body needs time to respond to treatment and tap into its capacity for self-healing. It is not uncommon to feel some soreness and pain after initial treatment.
  • In contrast to active sportspeople, those with more sedentary office-based jobs may also experience conditions treatable by osteopathic treatment. These include back pain resulting from poor posture and repetitive strain injuries.

Closing statement

DO’s have the same education as MD’s with extra training in diagnosing and treating issues with the body’s framework. While the lines between DOs and MDs can be sometimes blurry, osteopathy may be useful before progressing to other more costly or invasive interventions. This is because of its focus on the patient as a whole system and on prevention, both shared tenets across many alternative practices.

In the future, we could have a collection of various approaches that each person much choose from or a synthesis of allopathic and holistic approaches. Regardless, osteopathic doctors will have a centric place for the challenges confronting the world in the years ahead.