Spinal manipulative therapies are those that are used on the human skeleton, particularly the spinal area, to relieve muscular or skeletal pain, relieve tension, improve the mobility of joints and, in the case of the oriental therapies, to "unblock energy channels." The idea behind spinal manipulation is that when the vertebrae are subluxated (misaligned), the resulting pressure on nerves can have negative effects on organ system function and general health, in addition to impeding proper joint motion.
Forms of manipulative therapy have been used for thousand of years in Asia. The nineteenth century, however, saw the introduction of many new forms of manipulative therapy in the West. The best known and most widely used of these approaches are osteopathy and chiropractic. Most areas and societies have some tradition of manipulation or massage and osseous adjustments.
Osteopathy and chiropractic in particular have been used to relieve spinal pain and immobility. Both of these therapies can be used in cases of a "slipped disk," and are also used after accidents or surgery to restore mobility. Osteopathy and chiropractic can treat problems of the bones, muscles, joints, or ligaments. They have been used in the treatment of headaches of nervous origin, and even osteoarthritis. Athletes and dancers commonly seek osteopathic or chiropractic treatment for sports or occupational injuries to restore function.
A common practice among the spinal manipulative therapies is that the therapist will generally work on patients while they are lying on a special treatment couch adjusted to the height of the practitioner. The therapies vary from light touching to fairly vigorous manipulation.
The cost of treatment across the various disciplines varies a great deal according to the practitioner's level of qualification, the area of competence, and other factors.
Fully qualified osteopaths undergo four years of post-collegiate training in a college of osteopathy. They must pass state licensing examinations, and are entitled to use MRO (Member of the Register of Osteopaths) after their name. A DO is one of only two types of qualified physician in the United States, the other being an MD (allopathic physician). DOs are qualified to practice surgery, prescribe medications, and offer the same health care services that their allopathic counterparts are. The chief difference between the two groups of physicians is that MDs are more likely to enter specialized branches of medicine, while most DOs enter primary care practice.
Many aspects of traditional osteopathic philosophy, such as advice about diet and smoking, have entered mainstream medicine to the point that the lines between DOs and MDs are blurring. In addition, the dedication of osteopaths to holistic medicine and primary care has been a great benefit to rural areas of the United States that are often understaffed by mainstream practitioners.
Chiropractors are required to take two years of college with a relevant biological curriculum, and four years of resident study that must include supervised clinical experience. A further two years of practical or clinical studies is required, which must include diagnosis and disease treatment.
The Council on Chiropractic Education (CCE) and its Commission on Accreditation is an autonomous national organization recognized by the United States Department
Generally, no special preparation is required prior to treatment with the various kinds of spinal manipulative therapy, but some practitioners insist on x rays before treatment.
The licensing credentials of spinal manipulation practitioners should always be checked. They should also be given any information regarding the health of the patient that may be relevant to treatment.
In the presence of serious spinal problems, damage could result if the practitioner is not properly qualified. A registered practitioner should always be consulted, and should be made aware of all relevant patient information.
Osteopathy and chiropractic are now well accepted as options for the treatment of back pain and many types of sports injuries. The field of sports medicine has found particular benefit in osteopathic practitioners because of their emphasis on the musculoskeletal system, manipulation, diet, exercise, and fitness. Many professional sports team physicians, Olympic physicians, and personal sports medicine physicians are doctors of osteopathy (DOs).
Shealy, Norman C. Alternative Medicine, An Illustrated Encyclopedia of Natural Healing. Boston, MA: Element Books, 1996.
"Osteopathic Manipulative Treatment May Benefit Patients." Health & Medicine Week (October 8, 2001).
Shepard, Scott. "Health Philosophies on Common Ground." Cincinnati Business Courier 18 (November 9, 2001): 38.
American Association of Colleges of Osteopathic Medicine. 5550 Friendship Blvd., Suite 310, Chevy Chase, MD 20815-7231. (301) 968-4100. <http://www.aacom.org>.
The American Chiropractic Association. 1701 Clarendon Blvd, Arlington, VA 22209. (800) 986-4636. Memberinfo@amerchiro.org. <http://www.amerchiro.org>.
American College of Chiropractic Consultants (ACCC). 28 E. Jackson Bldg., 10th Fl., Suite 1020 Chicago, IL 60604. <http://www.accc-chiro.com>.
American Osteopathic Association. 142 East Ontario Street, Chicago, IL 60611 (800) 621-1773. msc@aoa-net.org. <http://www.aoa-net.org>.
American Osteopathic Board of Neuromusculoskeletal Medicine. 3500 DePauw Boulevard, Suite 1080, Indianapolis, IN 46268-1136.
The General Council and Register of Osteopaths. 56 London Street, Reading, Berkshire RG1 4SQ, United Kingdom.
Patricia Skinner
Rebecca J. Frey, PhD