Osteopathy: What's old is new again

If someone were to invent osteopathic medicine today, it would be launched with much brouhaha as the newest in holistic, mind-body healing.

Dr. Andrew Taylor still would become an instant celebrity, much in demand for appearances on morning and late-night TV shows. He would explain how his philosophy was based on ideas that date back to Hippocrates and focus on the unity of all body parts. He would say the musculoskeletal system was a key element of health and place much emphasis on the body’s ability to heal itself. Finally, he would stress preventive medicine, proper eating and keeping fit.

Though it sounds startlingly contemporary, Still actually introduced osteopathic medicine more than 100 years ago in the late 1800s. A couple of years later, he began to teach it, and he founded the first college of osteopathic medicine.

Today, there are about 55,000 osteopathic physicians, known as doctors of osteopathy, or D.O.s, in the United States.

Seeking a better understanding of osteopathic medicine, I recently interviewed Dr. Richard Van Buskirk, a Sarasota-based doctor of osteopathy.

What is osteopathy?
Osteopathic medicine is an American-born medical profession dating to the late-19th century when a Midwestern doctor wanted to do something for patients besides poison them, addict them or cut things off. Still created osteopathy as an option to medicine as it was then being practiced. He believed that if he could help people find musculoskeletal balance and harmony, they could do a better job of healing themselves.

All osteopathic medical students receive additional training in musculoskeletal manipulative medicine that is not included in the M.D. curriculum. Otherwise, the educations differ little.

In recruiting students, the osteopathic medical schools may place slightly less emphasis on scores and grades and more on commitment to helping people heal. Some 60% of osteopathic students do M.D. residencies (in mixed-staff hospitals), because there simply are not enough osteopathic hospitals to accommodate them. In terms of education, it is difficult to distinguish D.O.s from M.D.s.

Typically, people see D.O.s for musculoskeletal pain or restriction or because they’ve been told they need surgery and want to explore a second opinion. Oftentime, people who are on narcotics for pain management are looking for an alternative.

Two things emerge as the major differences between conventional and osteopathic medicine.

The first is obviously focus on the musculoskeletal system — the bones, muscles, ligaments and other connective tissue that are the body’s architecture and mechanical engineering.

All of that accounts for 80% of the body by weight and volume, and it surrounds and interacts with all the other systems — circulation, respiration, digestion, etc. A key premise of osteopathy is that something out of balance in the musculoskeletal system can be a component, if not the exclusive cause, of a problem elsewhere. This gives the osteopathic physician a different and perhaps broader perspective on the symptoms with which he is presented.

A second differentiation is a broader view of the patient’s overall health, one that includes not just musculoskeletal balance but also mental, emotional and even spiritual aspects, and encompasses a belief that the body wants to heal.

Osteopathic treatment plans often include weight loss, movement-based therapies, including yoga, nutrition and other lifestyle modifications.

Musculoskeletal manipulation has been part of osteopathy from the start. Still developed what is now known as The Still Technique. His gentle, non-traumatic and specific method was one of seven or eight that were in use by the end of the century. Its popularity waned around 1920 because it required so much time and skill to practice. But until the 1980s, virtually all D.O.s did some form of musculoskeletal manipulation as part of their practice, regardless of specialty.

Manipulation declines
According to Van Buskirk, the use of manipulation has fallen off since then because it is physically demanding to do and because of the desire of D.O.s to be like M.D.s. Van Buskirk was instrumental in the rediscovery and redevelopment of the Still Technique, and his book on it has become the primary teaching text.

Van Buskirk went to medical school at age 36 when he already had a Ph.D. and was a professor of physiology. Because of his academic background, he is sought after as a diagnostician and often sees difficult cases — patients who have had surgery that didn’t work or are worried whether they need a surgery. “Most of the time,” he says, “they don’t.”

A sign that osteopathic medicine has found its way into the mainstream is that mainstream medicine is embracing many holistic, osteopathic concepts.

Molly Schechter is an ACE-certified personal trainer, with a specialty in older adult fitness plus YogaFit Instructor Training and a Power Pilates(tm) Mat Certification. She teaches classes at the Bayfront Park Recreation Center. E-mail her at [email protected].