1 / 28

Introduction to Osteopathic Medicine

Introduction to Osteopathic Medicine. Ronald Januchowski, D.O. Associate Dean, VCOM. Objectives. Review the history of Osteopathic Medicine Introduce / review some common techniques Practical applications. History of Osteopathic Medicine. Some dates

pelham
Download Presentation

Introduction to Osteopathic Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Introduction to Osteopathic Medicine Ronald Januchowski, D.O. Associate Dean, VCOM

  2. Objectives • Review the history of Osteopathic Medicine • Introduce / review some common techniques • Practical applications

  3. History of Osteopathic Medicine • Some dates • 1874 – basic principles first articulated by A.T. Still, M.D. • 1892 – first college founded in Kirksville, Missouri • 1950 – start of full practice rights • 1967 – draft extends to D.O. • 1973 – full practice rights in all 50 states

  4. History of Osteopathic Medicine • Basic tenets of Osteopathic Medicine • The body is a unit, and the person represents a combination of body, mind, and spirit. • The body is capable of self-regulation, self-healing, and health maintenance. • Structure and function are reciprocally interrelated. • Rational treatment is based on an understanding of these principles: body unity, self-regulation, and the interrelationship of structure and function

  5. History of Osteopathic Medicine • Evolution of mission and identity

  6. History of Osteopathic Medicine – Growth FIRST YEAR ENROLLEMENT IN D.O. SCHOOLS

  7. History of Osteopathic Medicine – Growth • Medical schools in the U.S. • 34 D.O. schools • 137 M.D. schools

  8. History of Osteopathic Medicine – % by state Location of osteopathic medicine schools are shown in red % of physicians in state<3%3-5%5-10%10-15%15-25%

  9. History of Osteopathic Medicine D.O. vs. M.D.’s D.O. M.D. 4 years of medical school Residency training Licensing exam Unlimited medical practice Use of medicines and/or surgery • 4 years of medical school • Residency training • Licensing exam • Unlimited medical practice • Use of Osteopathic Manipulative Treatments in addition to medicines and/or surgery

  10. History of Osteopathic Medicine D.O. vs. Chiropractors D.O. Chiropractic Medicine 4 years of chiropractic school Use of spinal adjustment is main method of treatment Limited practice licensure • 4 years of medical school • Manipulation as one method of many treatment methods • Fully licensed, unlimited practice physicians

  11. Terminology - Diagnosis • Somatic dysfunction • Impaired function of the body framework • Treatable using OMT • Described using • Position of the part • Direction which motion is best or limited • TART

  12. Terminology - Treatment • Soft tissue techniques • Effluerage / lymphatic techniques • Counterstrain • Muscle Energy • HVLA

  13. Terminology – Treatment • Soft tissue stretching • Lengthening linear/band muscles • Gentle technique • Can be performed on acute injuries

  14. Terminology - Treatment • Effleurage • Gentle technique • Improves lymphatic flow • Reduces sympathetic tone to the area • Lymphatic pump • Generally gentle • Improves lymphatic flow

  15. Terminology – Treatment • Counterstrain • Gentle technique • Find a dysfunction and place the area in a position of comfort • Hold for 90 seconds and return to neutral position

  16. Terminology - Treatment • Muscle Energy • Take dysfunction to barrier • Resist movement away from barrier • Repeat • Works for small or large areas • Gentle technique

  17. Terminology - Treatment • High Velocity Low Amplitude (HVLA) • Takes an area of dysfunction to a barrier • Thrusting through the functional barrier to improve movement

  18. Headaches in History

  19. Headaches in History

  20. Headache Types • Primary • Migraine (with and without aura) headache • Tension-type headache • Cluster headache • Secondary • Sinus related • Vascular (AVM, aneurysm) • Post trauma • Structural or metabolic derangements

  21. Exam findings • Structural exam findings • C1-C3 somatic dysfunction • Tender points in particular headaches • Frontal & orbital (C1, occipitomastoid) • Periorbital (C2, occipitomastoid, infraorbital and nasal) • Occipital (C4) • Motion restrictions in OA area • Scapular / upper thoracic dysfunction • Sacral dysfunction sometime involved

  22. Acute Treatment Plan • Treat rapidly • Restore patient’s function • Optimize self-care • Minimize side effects

  23. Acute Treatment – TTH • Aspirin • Acetominophen • NSAIDs • Ibuprofen, Ketoprofen, Naproxen • Ketorolac • Combinations with caffeine • Excedrin Migraine, Advil Migraine

  24. Acute Treatment – TTH • Butalbital or codeine combos • Not recommended for general patients because of side effects and/or overuse • May be used in patients who cannot use to other meds (pregnancy, renal failure) • Triptans, Muscle relaxants • Not effective in pure TTH • Other methods • OMT • Ice, biofeedback

  25. Preventive Treatment – TTH • Amitriptyline • SNRIs • Mirtazipine • Venlafaxine • SSRIs – no benefit over placebo • Anticonvulsants – limited data • Gabapentin • Topiramate

  26. Preventive Treatment – TTH • Tizantidine – limited studies • Botulinum toxin – no effect over placebo • Behavioral therapy – limited studies • Physical modalities • Spinal manipulation / OMT was less effective than Amitriptyline for initial pain, but had better lasting effect and less side effects • Craniocervical exercises effective

  27. Osteopathic techniques for headache treatment • Soft tissue techniques • OA / Cervical Spine / rhomboids • Counterstrain • OA / Cervical • Muscle Energy • Scalenes • HVLA • Lumbar roll

  28. Questions?

More Related