Osteopathic Manipulation

About OMT

Osteopathic Manipulative Therapy (OMT) consists of a series of corrective HVLA thrusts and/or mobilizations to restore and maintain proper spinal and extremity motion. This service can include each of the three spinal regions (cervical, thoracic, lumbar) as well as specialized techniques aimed at the craniocervical, cervicothoracic, thoracolumbar, lumbosacral and extremities articulations and soft tissues. The techniques used may include seated, standing, prone, and supine positions. OMT as compared to chiropractic care is often associated with more advanced soft-tissue and neuromusculoskeletal/physiologic techniques.

The OMT at SEC is primarily HVLA techniques intermixed with soft tissue manipulation such as Myofascial Release, Muscle Energy, Strain/Counterstrain, and trigger point therapy. It is often used in conjunction with our regenerative medicine modalities but can be used alone. We offer our OMT services at self-pay cash rates.

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What to Expect

If you have never experienced a spinal osteopathic manipulative treatment (OMT) or chiropractic adjustment then you may not be sure what to expect on the first visit. The doctor will begin by taking a thorough medical history and completing an evaluation of your spine and extremities. Once it is determined you are a good candidate for care and there are no contraindications, you will receive your first spine or extremity manipulation/mobilization.

An HVLA (high velocity, low amplitude) manipulation is a light to moderate quick force into the spinal or extremity articulations that have restricted motion. This restricted motion may result in functional limitations, muscular imbalances/spasms, or create pressure on the discs, joints, and nerves in the surrounding area. This is commonly called a somatic dysfunction in the osteopathic literature. Other soft tissue techniques may be utilized.

Frequently Asked Questions

IS "OMT" the same as a chiropractic "adjustment"?

In many cases, yes. We use manual techniques derived from both osteopathic medicine and chiropractic. However, we only use the techniques that are effective in restoring proper spinal and extremity motion, primarily high velocity, low amplitude (HVLA) thrust techniques. We do not use unproven "adjustment tools" or "activators". The soft-tissue techniques used are derived from researched osteopathic medicine and physical therapy.

How often should I be seen?

This depends on your condition, history of prior spinal manipulation, activity level, and desired results. For example, patients who have received regular care from a chiropractor, have a typical activity level, and are not experiencing significant new problems may only need to be seen 1-2 times a month. A patient that is experiencing more significant symptoms, has not seen a chiropractor before, or has a very physically strenuous lifestyle may benefit more from an initial treatment plan of 2-3 x a week for several weeks tapering into a maintenance plan within a month or two. Athletes and active adults who desire peak performance would likely benefit from 3-4 treatments a month during their active times, and 1-2 x a month otherwise.

What is the preferred term for high-velocity, low amplitude treatments (HVLA)?

Any term that you feel communicates your desired treatment from us is acceptable. The terminology across manual medicine providers varies. For example, regarding your neck, an osteopathic physician is likely going to refer to it as “cervical HVLA”, a chiropractor will use the term “adjustment”, and a physical therapist would likely refer to is as “cervical HVLA” or a “Grade 5 mobilization”. As Spine and Extremities Center is a multidisciplinary center, we often refer to it as SMT, short for Spinal Manipulative Therapy. Our DO/DC doctors have collaborated and only use the techniques from osteopathic medicine,, physical therapy, and chiropractic that have a medical basis for use. We do not use unproven or gimmicky “adjustment” tools or ineffective treatments.

What causes the "popping" sounds?

The exact cause is still unknown despite much research. It is likely a combination of sounds from both joint and soft tissue origins. Patients typically feel a significant release of pressure in the area treated and immediately have an increased range of motion as the soft tissue restrictions are released and the joint is allowed to move freely. Pain is reduced as the mobilization causes immediate inhibition (reduction) in pain impulses into your central nervous system. This is referred to as "manipulation induced anesthesia", or "MIA".

Who is not a candidate?

We check your history carefully. Generally spinal areas that have had surgery cannot be manipulated with HVLA techniques, but the other areas can be. Patients with osteoporosis, aneurysms in the region being treated, and active cancer or infection in the spine are not candidates. In post-surgical and osteoporotic spines we can use other soft-tissue and mobilization techniques to help treat myofascial dysfunction.