Osteopathic manipulative medicine (OMM) is a comprehensive approach to health care in which osteopathic physicians (DOs) apply osteopathic philosophy, structural diagnosis and use of osteopathic manipulative treatment (OMT) in the diagnosis and management of patients.
The art and science of OMM pertain to the assessment of the impact of the malfunctioning neuromusculoskeletal systems on health and disease, and designing appropriate interventions which often include some form of OMT. There are approximately 15 major types of OMT and more than 1,000 individual techniques.
At its heart, osteopathic manipulative medicine is the knowledge base that allows the osteopathic physician to determine which patients will derive the greatest benefit from OMT and which specific techniques should be applied.
The impact on the health of the individual may occur via several well defined mechanisms:
If it is crooked, make it straight. If it is stiff, make it move. At its most basic, this is the biomechanical approach. The musculoskeletal system is the primary machinery of life. The more efficiently it works, the less energy is expended in just day-to-day living. This has a beneficial impact on a host of conditions, most notably cardiopulmonary disease and diabetes mellitus. Additionally, mechanical problems are a common source of musculoskeletal pain syndromes, so this approach is commonly used for back pain, neck pain, headache and many other painful conditions.
Restricted movement of the musculoskeletal system can provoke the development of inappropriate reflex neural responses that will have an adverse effect on the function of the individual. These may take the form of somato-visceral reflexes—those affecting the internal organs—and somato-somatic reflexes—those affecting other parts of the musculoskeletal system. Less commonly, musculoskeletal dysfunction can directly impinge on neural structures. Examples of this include thoracic outlet syndrome and sciatica due to compression by the piriformis muscle.
Compression of the components of the vascular system by abnormal position or tension in the neuromusculoskeletal structures can lead to tissue ischemia, congestion and edema. There are also manual medicine techniques to improve circulation to and from various parts of the body in the presence of other disease states.
Osteopathic treatments have been shown to have powerful beneficial pulmonary effects, improving lung function and patients' ability to recover from illness. Osteopathic treatments are used to improve air exchange, motion of the diaphragm, rib motion and to help remove unhealthy fluid from the lungs, as well as to help the body's inherent ability to heal, all of which leads to quicker recovery times from pneumonia, as well as helping patients with conditions such as bronchitis, influenza, asthma and ear infections.
Several manipulative techniques have been demonstrated to increase the body’s response to infection, regardless of type or location. This generalized improvement in the immune response has been shown to prevent respiratory failure and death in elderly patients with pneumonia.
The better an osteopathic physician gets to know his or her patient, both through conventional medicine and hands-on osteopathic care, the better the care plan can be personalized to the needs of the individual. Osteopathic physicians try to help the person who has a concern or problem, as well as dealing with the problem itself. Another way of saying this is that osteopathic physicians treat the patient, not just the problem.