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OSTEOPATHIC CARE FAQs
What Is Osteopathic Manipulation?
Osteopathic Manipulation—also called Osteopathic Manipulative Treatment (OMT)—is a hands-on, physician-directed approach that restores healthy motion and balance throughout the body. It is based on the understanding that structure and function are interdependent, and that when the body moves freely and efficiently, it can better self-regulate and heal.
Osteopathic medicine was founded in the late 1800s by Andrew Taylor Still, MD, DO, who sought a more comprehensive, anatomy-based approach to patient care. He observed that structure and physiology were inseparable and developed a system of diagnosis and treatment centered on restoring motion and balance to the body’s framework to promote health.
Over time, this philosophy evolved into a full branch of medical practice—recognized and licensed in all 50 states—where osteopathic physicians are trained in both conventional medicine and manual therapy. Modern osteopathic manipulation integrates these original principles with current biomedical understanding, maintaining its focus on treating the whole person rather than isolated symptoms.
Osteopathic physicians (DOs) are fully licensed medical doctors who receive specific training in the musculoskeletal system and its role in health. Those who complete additional residency training in Osteopathic Neuromusculoskeletal Medicine (ONMM) receive the most advanced education in osteopathic manipulation, developing expertise in diagnostic palpation, functional anatomy, and integrative management of complex musculoskeletal and neurologic conditions.
How It Works
Osteopathic medicine emphasizes the relationship between structure, function, and the body’s built-in healing mechanisms. These foundational principles guide every osteopathic treatment:
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The body is a unified system. Physical, neurologic, and circulatory processes work together; changes in one area can influence the whole.
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Structure and function are interrelated. Restrictions in motion or alignment can alter efficiency and create imbalance.
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The body has self-regulating, self-healing capabilities. The physician’s role is to support and optimize these natural processes rather than override them.
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Treatment is guided by these principles. Care is individualized based on how each patient’s structure relates to overall health and function.
Building on these concepts, osteopathic manipulation is performed through direct, hands-on engagement with the body’s muscles, joints, and connective tissues.
The physician uses precise, gentle techniques to improve motion, reduce strain, and restore balance in restricted areas.
This process:
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Restores normal joint and regional motion, allowing movement and load to distribute more evenly throughout the body.
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Relieves excess muscle tension and enhances circulatory and lymphatic flow, supporting tissue recovery and reducing local inflammation.
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Improves respiratory and postural mechanics, promoting more efficient breathing and coordinated gait.
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Rebalances nervous system tone and proprioceptive control, reducing pain sensitivity and improving overall functional integration.
When these relationships are normalized, the body moves and functions with less strain, supporting recovery, balance, and long-term stability.
Role in Comprehensive Care
Osteopathic manipulation is often integrated with other medical and rehabilitative treatments—such as physical therapy, exercise programs, or acupuncture—to enhance recovery and minimize the need for invasive interventions.
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It is appropriate for a wide range of musculoskeletal and functional concerns, from postural strain to joint or nerve-related pain. Each session is tailored to your unique findings and health goals.
What to Expect
At your visit, the physician performs a structural evaluation to identify areas of restricted motion or imbalance that may be contributing to symptoms.
Treatment involves gentle, targeted techniques applied while you are comfortably positioned on the treatment table. Sessions typically last 20–30 minutes, depending on the complexity of your condition.
Many patients feel a sense of relaxation or improved mobility immediately following treatment. Mild soreness is occasionally noted for a day or two as tissues adjust. The physician will review your response and provide guidance on posture, activity, or home exercises to support continued improvement.
Summary
Osteopathic manipulation is a hands-on medical treatment that helps restore motion, balance, and physiologic harmony throughout the body. Guided by advanced training in Osteopathic Neuromusculoskeletal Medicine, it integrates clinical expertise with precise manual evaluation to reduce pain, improve movement, and support the body’s natural healing capacity.
What Is Medical Acupuncture?
Medical acupuncture refers to the administration of acupuncture by licensed physicians (MDs or DOs) who have incorporated acupuncture into their medical practice. These physicians evaluate and diagnose through a modern medical lens, then use acupuncture as one part of an overall plan to relieve pain, restore function, and promote healing.
How It Works
In classical acupuncture theory, energy pathways (known as meridians) flow through the body; disruptions in these flows may affect health and function.
From a modern medical perspective, acupuncture activates a variety of physiologic and biomechanical responses that help the body regulate itself more effectively:
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Neurologic modulation: Stimulation of peripheral nerves alters signaling in the spinal cord and brain regions involved in pain processing, muscle tone, and visceral function.
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Autonomic balance: Acupuncture influences the sympathetic and parasympathetic nervous systems, supporting regulation of heart rate, circulation, and stress response.
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Neurochemical release: Needling triggers localized and systemic release of endorphins, serotonin, and other neurotransmitters that reduce pain and enhance well-being.
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Circulatory effects: Increased local blood flow improves oxygenation, nutrient delivery, and removal of inflammatory byproducts.
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Biomechanical response: Needle insertion and micro-manipulation can produce measurable tissue deformation that affects connective tissue tension, alters fascial glide, and improves neuromuscular coordination. These mechanical effects may directly influence joint motion, posture, and muscle recruitment patterns.
Together, these mechanisms contribute to reduced pain, improved movement, and restoration of functional balance throughout the body.
Role in Comprehensive Care
Medical acupuncture is frequently integrated with other conservative treatments—such as osteopathic manipulation, physical therapy, and rehabilitative exercise—to enhance recovery and reduce dependence on medication or invasive procedures.
Because it is performed within a physician’s diagnostic framework, each treatment is tailored to the patient’s specific medical condition, goals, and overall care plan.
Insurance Coverage
Most major insurance plans now cover acupuncture for chronic low back pain, reflecting its established role in conservative pain management. Coverage for other conditions varies among insurers and may not yet be included in standard benefits.
What to Expect
Your physician will review your medical history and determine how acupuncture fits into your care plan. Very fine, sterile needles are placed at selected points or regions and remain in place for several minutes while you rest.
Many patients describe sensations of warmth, heaviness, or relaxation during treatment. The number and frequency of sessions depend on the nature of the condition and the individual’s response to therapy.
Summary
Medical acupuncture combines the diagnostic insight of modern medicine with the therapeutic principles of acupuncture to support the body’s natural capacity for healing. By influencing neurologic, circulatory, and biomechanical systems, it offers a safe, conservative path toward improved function and pain reduction within a comprehensive medical approach.
What Is Nerve Hydrodissection?
Nerve hydrodissection is a minimally invasive, ultrasound-guided procedure used to free a peripheral nerve from surrounding tissues that may be compressing or tethering it. Using precise ultrasound visualization, a fine needle is advanced alongside the nerve, and fluid is injected to create space around it and restore normal mobility.
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This technique allows the physician to directly address irritation or entrapment of nerves that can contribute to pain, tingling, or weakness in the affected region.
How It Works
Under real-time ultrasound guidance, the physician identifies the nerve and the nearby fascial or muscular layers restricting it. A small amount of sterile fluid—commonly saline, 5% dextrose, and a small amount of anesthetic—is injected to gently separate the nerve from its surrounding tissue planes.
This process:
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Mechanically releases adhesions and allows the nerve to glide freely
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Reduces compression on the tiny blood vessels that nourish the nerve
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Improves local circulation and decreases mechanical irritation
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Provides short-term numbing from the anesthetic component
In addition to helping physically free the nerve, the 5% dextrose (D5W) used in this procedure provides other benefits for nerve health. Research shows that dextrose can help calm irritated nerves and reduce abnormal pain signaling. It does this in a gentle way—without damaging the nerve tissue—by creating a soothing environment that allows the nerve to recover and function more normally. The small amount of natural sugar in the solution also provides a mild source of energy for nearby cells, which may support local healing and tissue repair.
Together, these effects help restore motion, reduce inflammation, and promote recovery of normal nerve function.
Role in Comprehensive Care
Nerve hydrodissection is typically considered when symptoms persist despite conservative management such as osteopathic manipulation, physical therapy, or activity modification. It can be used as a stand-alone procedure or alongside other ultrasound-guided injections to improve comfort and function.
Nerve hydrodissection is covered by insurance.
What to Expect
The procedure is performed in the office and usually takes less than 30 minutes. The skin is cleansed, and the area is numbed with a small amount of local anesthetic. The physician then uses ultrasound to guide the needle precisely next to the affected nerve before introducing the fluid.
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Most patients notice a sensation of pressure or warmth as the fluid separates tissue layers. Mild soreness can occur for a day or two afterward, but recovery is typically rapid, with return to usual activity within 24–48 hours. Multiple treatments may be required in chronic or complex cases depending on the degree of nerve involvement.
Summary
Nerve hydrodissection uses targeted, ultrasound-guided fluid injection to release peripheral nerves entrapped by surrounding tissue. By restoring nerve mobility, improving circulation, and supporting nerve recovery with 5% dextrose, it offers a precise, low-risk option for symptom relief within a conservative, non-surgical treatment plan. The procedure is covered by insurance.
What Is Prolotherapy?
Prolotherapy is a minimally invasive, ultrasound-guided injection treatment used to help strengthen and stabilize ligaments, tendons, and joint-supporting tissues that have been strained or weakened over time. It is designed to reduce pain and improve function by supporting the body’s natural repair processes.
It is most often used for chronic ligament or tendon-related pain, joint instability, or persistent discomfort following injury.
How It Works
Prolotherapy involves the precise injection of a higher-concentration dextrose solution—distinct from the 5% dextrose used in nerve hydrodissection—mixed with a small amount of local anesthetic.
Using ultrasound guidance, the physician identifies the exact area where ligaments or tendons attach to bone and directs the injectate to those tissues.
This process:
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Gently stimulates local healing activity within the targeted connective tissues.
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Helps strengthen and tighten the supporting structures around joints.
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Can reduce mechanical strain and irritation that contribute to chronic pain.
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Provides short-term numbing from the anesthetic for immediate comfort.
Over time, this can lead to improved joint stability and better tolerance for daily movement and exercise.
Role in Comprehensive Care
Prolotherapy is typically considered when pain or looseness persists despite conservative measures such as osteopathic manipulation, physical therapy, or activity modification. It may be used as a stand-alone procedure or in combination with rehabilitation to reinforce stability as mobility and strength improve. Prolotherapy is not covered by insurance.
What to Expect
The procedure is performed in the office using real-time ultrasound guidance for accuracy and safety. The skin is cleansed, and a small amount of local anesthetic is applied before the injection. Discomfort during the procedure is usually brief, and most patients find it very tolerable.
Mild soreness or stiffness may occur for one to two days. Light activity can usually be resumed shortly after treatment. Results develop gradually over several weeks as the treated tissue heals, and a series of sessions is often recommended to achieve lasting benefit.
Summary
Prolotherapy uses targeted, ultrasound-guided injections of a higher-concentration dextrose solution to strengthen and stabilize supportive tissues around joints. By improving structural integrity and reducing irritation at key attachment points, it offers a safe, conservative option for pain relief and improved function with minimal downtime.
This procedure is not covered by insurance.
What Is Diagnostic
Musculoskeletal Ultrasound?
Diagnostic musculoskeletal ultrasound (MSK ultrasound) is a non-invasive imaging test that uses high-frequency sound waves to visualize muscles, tendons, ligaments, joints, nerves, and other soft tissues throughout the body.
It allows the physician to see what’s happening beneath the surface in real time—helping identify the source of pain, guide decision-making, and tailor treatment to each patient’s needs.
Unlike X-ray or MRI, ultrasound does not use radiation and allows the physician to observe motion and tissue behavior as they happen, making it ideal for evaluating soft-tissue pain or injury.
High-resolution ultrasound provides exceptional detail of superficial tendons, ligaments, and nerves—often with finer structural resolution than MRI for these areas—while MRI remains more useful for deeper structures or conditions beyond the reach of ultrasound.
How It Works
During the scan, a small amount of gel is applied to the skin, and a handheld probe (called a transducer) is moved gently over the area of concern. The sound waves pass through the tissues and reflect back to create detailed, real-time images on the screen.
Because ultrasound shows movement, the physician can assess how tendons glide, how ligaments respond to stress, and how muscles or nerves move during activity—something static imaging cannot capture.
The same high-resolution ultrasound equipment used for diagnostic imaging also guides procedures such as nerve hydrodissection, joint injections, and prolotherapy, allowing precise visualization and safer, more effective treatment.
Role in Comprehensive Care
Diagnostic musculoskeletal ultrasound is often used when physical examination alone does not fully explain a patient’s symptoms or when more precise imaging is needed to guide treatment.
It complements osteopathic manipulation, physical therapy, and image-guided procedures by clearly identifying which structure is involved and how it behaves in motion.
Because all evaluations are performed in-office using high-resolution ultrasound, results are immediate, and findings can be discussed in real time to inform your plan of care.
What to Expect
The scan typically takes 15–30 minutes and can often be performed during your regular visit.
There is no radiation and no discomfort beyond light pressure and gel application. You will remain dressed except for the area being examined and can return to normal activity right away.
Your diagnostic ultrasound can often be performed at the same visit as your evaluation, allowing the physician to immediately correlate findings with your symptoms and determine next steps.
Ultrasound is completely safe, produces no radiation exposure, and is well tolerated by all ages.
After the scan, the physician reviews the images with you, explains the findings, and discusses how they fit into your treatment plan.
Summary
Diagnostic musculoskeletal ultrasound is a safe, dynamic, and highly informative imaging tool that visualizes the body’s muscles, tendons, ligaments, joints, and nerves in motion.
By identifying the exact source of symptoms and providing real-time visual feedback, it enhances diagnostic accuracy, guides treatment decisions, and supports individualized, conservative care—all without radiation or downtime.
What Is Platelet-Rich Plasma
(PRP) Therapy?
Platelet-Rich Plasma (PRP) therapy is a minimally invasive, ultrasound-guided injection treatment that uses your own concentrated platelets to support healing in injured or irritated tissues. The goal is to achieve high-concentration PRP, meaning platelets are processed and concentrated well above their normal level in the bloodstream before being precisely injected into the target area.
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PRP therapy is used to help reduce pain and improve function in areas such as tendons, ligaments, and joints. It is commonly applied for chronic tendon or ligament pain, osteoarthritis, and overuse injuries that have not fully improved with standard conservative care.
How It Works
A small amount of your blood is drawn and processed in a centrifuge to separate and concentrate the platelets. The platelet-rich layer is then collected and injected, using ultrasound guidance, directly into the affected tissue.
This process:
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Delivers a concentrated source of platelets and natural growth signals to the area of injury.
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Supports local tissue healing and repair.
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Helps reduce irritation in chronically inflamed or degenerated tissues.
Because every injection is performed under real-time ultrasound, placement is precise, targeting the exact structures that need treatment.
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Role in Comprehensive Care
PRP is typically considered when symptoms persist despite conservative measures such as osteopathic manipulation, physical therapy, or activity modification. It can be integrated with these same therapies to optimize recovery and restore healthy movement patterns as the tissue heals. PRP is not covered by insurance.
What to Expect
The procedure is performed in the office and usually takes about 45 minutes, including blood draw and preparation. Afterward, mild soreness or stiffness may occur for several days. Most patients can resume light activity soon after treatment. Results develop gradually over several weeks as the treated tissue heals and responds to the platelet-derived growth signals. Multiple sessions may be recommended for chronic or complex conditions.
Summary
PRP therapy uses high-concentration platelets from your own blood, delivered by ultrasound-guided injection, to support recovery in painful or weakened tissues. It offers a safe, conservative option for reducing pain and improving function in tendon, ligament, and joint-related conditions such as osteoarthritis. This procedure is not covered by insurance.