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Osteopathic medicine: a call for reform.

During the past 40 years, the osteopathic medical profession has undergone a transformation from "osteopathy" to "osteopathic medicine." The former was characterized by manipulative treatment; the latter, by full-service healthcare. During this transformation, the profession has won acceptance from the government, the military, and MDs. These changes in status have resulted in new problems for the profession because DO graduates are increasingly turning toward allopathic programs for residency training. Thus, osteopathic medicine's primary care orientation is being replaced by an emphasis on specialty training. The authors propose that osteopathic medicine return to its original mission of primary care, abandon or restrict specialty training to those who have completed primary care residencies, and rethink its separate-but-equal posture. They also propose that osteopathic medicine establish lines of communication with allopathic medicine, the American Medical Association, and the government to facilitate the development of a rational national policy for primary care that considers the potential osteopathic medicine has to offer in meeting the nation's primary care needs.

Education, Medical, Graduate↗

Osteopathy--an aid to the healing process.

1. Osteopaths deal primarily with the dysfunction of joints and the resulting effects. 2. Osteopaths believe that the body is able to heal itself and that their role is to aid this process. 3. Spinal dysfunction has wide-ranging effects on all bodily systems. 4. Osteopaths use a wide variety of techniques, not just supposedly painful manipulations, and treat both spinal and non-spinal problems.

Humans↗

[Manipulations].

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Bone Diseases↗

Back pain in osteopathic practice.

The case records of 5310 patients attending Registered Osteopaths were examined in this retrospective study. Analysis of the data revealed that over half presented with low back pain and were comparable to those normally seen in orthodox medical practice, except that their symptoms were of longer duration. The patients were generally examined in a conventional manner but it was not possible to identify specific diagnostic categories. The majority received one or more manual therapeutic techniques but 6% were rejected as unsuitable for treatment. The implications of the results for future research are discussed.

Adolescent↗

Sudden sensorineural hearing loss following manipulation of the cervical spine.

Review of the otolaryngologic literature reveals no reports of sudden sensorineural hearing loss resulting from manipulation of the cervical spine. Indeed, in previously reported cases of vertebrobasilar artery injury following spinal manipulation, hearing loss has received little attention. Two patients with sudden sensorineural hearing loss following cervical spine manipulation are presented. The audiologic findings and cerebral arteriograms are reviewed and treatment is discussed. A review of the anatomy and pathophysiology is also included, and a possible mechanism of injury to the vertebral artery is proposed.

Adult↗

Repositioning maneuver for benign paroxysmal positional vertigo (BPPV).

With vertigo, the symptom of unsteadiness is a common presenting complaint and the etiology protean. However, the specific subset of this patient population with benign paroxysmal positional vertigo (BPPV) is more defined. Cupololithiasis and canalithiasis are perhaps the best known and best described pathologic conditions resulting in vertigo. This condition occurs when otoconia from the utricle are displaced into the Posterior semicircular canal-cupula. The abnormal position of the otoconia often results in a pathological condition. The location of displacement is most often in the posterior semicircular canal. A better understanding of the etiology of BPPV has led to a simple and effective particle repositioning maneuver that allows the practitioner to alleviate vertigo symptoms for most patients using a simple manipulation.

Calculi↗

[The acute cervical vertigo under otologic and osteopathic view (author's transl)].

The acute cervical vertigo with the single symptome of rotary vertigo is most probably caused by a functional disturbance in the upper third of the cervical spine. Distinct patho-anatomical changes could not be observed. The findings on the cervical spine are based on an osteopathic examination. The therapy of choice is a manipulation. Three cases are reported.

Adult↗

Myofascial release of carpal tunnel syndrome.

Current treatment for carpal tunnel syndrome may be ineffective or associated with complications or recurrence. In the case reported here, a myofascial release by the physician combined with the patient's self-stretch reduced pain and numbness and improved electromyographic results. The manipulative approach releases the transverse carpal ligament,-and "opens" or dilates the canal. The patient stretches the wrist, digits, and thumb, including myofascial components. An aggressive, conservative approach lessens the need for surgery in mild to moderate cases. Studies with magnetic resonance imaging may be helpful to document canal size before and after treatment.

Carpal Tunnel Syndrome↗