Osteopathic Manipulative Treatment

OMT is a set of hands-on techniques that osteopathic physicians (DOs) use to diagnose and treat problems in the musculoskeletal system (muscles, bones, and joints) and the systems connected to it, including the nervous, circulatory, and lymphatic systems. Techniques range from very gentle approaches, like myofascial release and cranial osteopathy, to more active ones. I tailor each treatment to your body and your comfort level.

MDs (Doctors of Medicine) and DOs (Doctors of Osteopathic Medicine, sometimes called osteopaths or osteopathic physicians) are both fully licensed physicians in the United States. Both complete four years of medical school and at least three years of residency, and both can practice in any specialty and prescribe medications.

DOs also complete hundreds of additional hours of training in osteopathic principles and OMT. Osteopathic medicine emphasizes caring for the whole person and the close connection between the body’s structure and how it functions.

Outside the US, “osteopath” often refers to practitioners who provide hands-on treatment but aren’t physicians. In the US, DOs are fully licensed physicians.

Chiropractors (DCs) are trained in hands-on care and are best known for spinal adjustments.

As a DO, I’m a fully licensed family physician with medical school and residency training. Along with OMT, I diagnose and treat a large range of medical conditions, prescribe medications and order and interpret tests when appropriate, and as the center of your health care team, I can help coordinate a lot of your care.

Most of the OMT techniques I use are gentle, with no cracking or popping, and can be used throughout the body.

If you already see a chiropractor that you find benefit from and with whom you want to continue care, OMT can complement that care, and I’d be happy to collaborate with them.

I primarily use gentle, indirect techniques. This means that rather than forcing a tight area to move, indirect techniques guide your body into a position of comfort and ease. This allows tense tissues to relax and your nervous system to settle. This approach is especially helpful and a good fit for people in significant pain, with a history of trauma, who feel anxious about hands-on treatment, and folks recovering from recent or long-term injury. Many patients find it deeply calming. Techniques I commonly use include:

• Myofascial release (MFR): Gentle, sustained pressure and stretch that releases tension in the fascia, the connective tissue that surrounds your muscles and organs.
• Strain/counterstrain: I find a tender point, then gently position your body so the tenderness eases. I hold that position for about 90 seconds, then slowly return you to neutral.
• Muscle energy: You gently tighten a specific muscle against my light resistance for a few seconds, then relax. Repeating this a few times helps tight muscles let go and improves how the joint moves. Because you’re actively involved, it restores motion without any forceful adjustment.
• Cranial osteopathy: Very light, subtle touch to the head, spine, and sacrum (the base of the spine) to support relaxation and nervous system balance.
• Facilitated positional release (FPR): I place your body in a position of ease and add a light, gentle force for a few seconds to release tension quickly.
• Balanced ligamentous tension (BLT): I gently guide a joint to the point where the ligaments around it are evenly balanced, then hold it there while your body releases the restriction on its own.

Most treatments involve no cracking or popping. I’m always happy to explain what I’m doing and adjust to your comfort.

OMT can support your body as it heals from many kinds of injury or stress. It can be especially helpful for:

• Low back and neck pain
• Headaches, including tension headaches and migraines
• Sciatica and other nerve-related pain
• Joint pain and stiffness (shoulders, hips, knees, and more)
• Sports injuries and repetitive strain
• Jaw tension and temporomandibular joint (TMJ) pain
• Discomfort during pregnancy and after childbirth
• Sinus congestion
• Digestive problems such as constipation
• Stress, anxiety, and nervous system regulation
• Sleep problems
• Circulation concerns
• General inflammation

OMT can also work well alongside other treatments. For conditions with many causes such as anxiety, OMT usually works best as a complement to other modalities like therapy or medication rather than a replacement.

OMT can be adapted for nearly everyone, from newborns to older adults, including during pregnancy. Some conditions, such as osteoporosis, recent fractures, certain cancers, or bleeding disorders, call for modified or gentler techniques. As part of the initial intake, I review your health history to make sure treatment is safe and appropriate for you, and in some cases I may request imaging before starting OMT for your safety.

Yes. OMT is considered very safe when performed by a trained osteopathic physician, and my focus on gentle, indirect techniques makes it especially low-risk. The most common side effects, if any, are mild soreness, tenderness, or tiredness for a day or two. Serious complications are extraordinarily rare. Before treating you, I review your medical history and do a hands-on exam to make sure OMT is right for you. If you have osteoporosis, a recent injury or surgery, a bleeding disorder, or are pregnant, I’ll adapt your treatment. You can always ask me to change or skip any technique.

Yes! OMT is available to everyone, members and non-members of all ages. It works best as part of a team, so I recommend also having a primary care clinician who can look after your overall health and arrange things like physical therapy, occupational therapy, or imaging when needed. Don’t have one? Becoming a Redwood member gives you primary care and discounted OMT in one place.

Your first visit is a comprehensive intake appointment that usually lasts 60 to 120 minutes. We’ll review your health history and current concerns, and I’ll do a hands-on structural exam. We’ll finish with a shorter OMT session. Return visits typically last 20 to 40 minutes, depending on what we’re treating.

Please wear comfortable, loose-fitting clothes that let you move easily, such as athletic wear or yoga clothes. For any folks with breasts, it can be helpful to wear a sports bra if you have one. You’ll stay fully clothed for most treatments. If possible, avoid jeans, belts, and bulky jewelry, or anything in your pockets since they can make it harder for me to assess and treat certain areas.

Treatment should never be painful. Most patients find OMT comfortable and often very relaxing (to the point that some fall asleep!). Some areas may feel tender while I work on them, especially if they’ve been tight or sore for a while. I adjust pressure and technique based on your feedback, so please let me know if anything feels uncomfortable. Mild soreness for a day or two afterward can occur similar to how you might feel after exercise or a massage. Drinking water, gentle movement and stretching, and an over-the-counter pain reliever (if it’s safe for you) can help any discomfort.

This depends on what we’re treating and how your body responds. A recent injury or new pain may improve within one to a few visits. Longstanding or chronic problems often benefit from a series of regular treatments, spaced further apart as you improve. We’ll reassess at each visit and build a plan together.

I would appreciate the opportunity to review any imaging reports or scans you have (CT scan, MRI, x-ray), especially if they are related to the area(s) you would like to address with OMT. I would also like to know what kinds of things you have tried before to address your concern (massage, medications, herbs, salves, heat/ice, other home remedies, etc.).