Osteopathic Diagnosis and Treatment

Dr. Still stated, “An osteopath reasons from his knowledge of anatomy. He compares the work of the abnormal body with the work of the normal body.” 1

Though each osteopathic physician is unique, a typical office visit usually consists of the following elements:

Medical history

Physical and osteopathic structural exam Osteopathic medical diagnosis Osteopathic treatment History

Before treatment can begin, it is important to take a thorough medical history, including a detailed description of traumatic events.

The osteopathic physician is interested in understanding the body’s adaptation to adverse influences. Both trauma and illness can disturb the tissues and alter function. As the tissues twist, compress and contract – fluid continuity becomes compromised, and normal physiology is impaired. If left untreated, this altered tissue function can remain present throughout a person’s life, long after the disruptive influence has passed.

An Osteopathic History may include questions about:

  • Birth
  • Injuries
  • Large singular impacts or strains
  • Multiple small impacts or strains
  • Inflammatory disease processes including prolonged high fevers Surgeries and residual scar tissue (adhesions) Dental Procedures Stress Emotional Physical Structural Exam

Following the history, a medical examination is performed, which includes pertinent physical and osteopathic structural evaluations. An osteopathic physician learns through touch. Dr. Sutherland often stated that osteopaths should have “thinking, feeling, seeing, and knowing fingers.”2

A structural exam can be performed either sitting, standing or lying down. Wearing loose, comfortable clothing allows the physician to optimally evaluate areas of bony asymmetry, tissue texture abnormalities, and fluid congestion.

The osteopathic physician will typically place his or her hands underneath or over some part of the body. Tissue function is evaluated; the quality of motion, its balance and organization are noted.


A thorough osteopathic diagnosis connects the patient’s history and physical exam to the structural evaluation. As the physician places his or her hands upon the patient, structural dynamics are perceived, and can often be directly linked to the patient’s presenting complaint and trauma history. A “cause and effect” relationship frequently emerges, and is an essential component of the osteopathic diagnosis. Patients are frequently relieved to know that their symptoms make sense.

For example, a patient presented with a history of headaches for 5 years. She tried many forms of medical treatment without real help. A history revealed a fall down the stairs, with an injury to her tail bone, several months prior to the onset of the headaches. Her headaches were finally relieved with osteopathic treatment of the structural problems related to her tailbone injury.


Treatment is typically very gentle. Tissues are supported and allowed to change. Usually very little force is used during treatment, but at times some force may be necessary. Diagnosis and Treatment are said to blend into one another. As tissues change the physician learns more about their nature. As the nature of the tissue dysfunction is better understood, the therapeutic response deepens.

Each patient’s experience is unique. Some patients sense only a gentle touch, while others feel their body change immediately. Some patients simply feel a deep sense of relaxation, and others feel nothing at all. Most patients feel a distinct change following the treatment

Though Cranial Osteopathy is very gentle, patients can occasionally experience some discomfort during certain stages of the treatment. When this occurs, it is simply a part of the healing process. As the treatment progresses, the discomfort subsides.

Although physicians practicing Osteopathy in the Cranial Field will work anywhere on the body, they may find it important to diagnose and treat the head. Though styles of treatment may vary, the osteopathic physician will primarily focus on the body’s “mechanism” – the body’s natural striving for health and normal function.

According to Dr.Sutherland, within each patient there is great wisdom, an inner physician, a wise all-knowing force that is the source of all healing. In his own words: “Allow physiologic function to express its own unerring potency rather than apply blind force from without.” 3

It is the osteopathic physician’s duty to listen, learn, support and allow, so that an optimal state of health can be realized and experienced.

All osteopathic physicians apply osteopathic principles in treatment. The styles of treatment in which these principles are applied vary from physician to physician.

How long does it take to see results?

Results depend upon many factors. Most significant are the body’s inherent vitality (ability to heal), the severity and the duration of the problem. Some conditions will respond immediately; some will require a series of treatments. It is important to understand that Cranial Osteopathy is not a cure-all. It can benefit everyone, because everyone has been imprinted individually by the traumas of life. For some patients it might be necessary to include other types of treatment. For many, Cranial Osteopathy is “the solution” to their problems.

References: 1. Still A.T., Osteopathy Research and Practice, Kirksville, MO, 1910, Reprinted by Eastland Press, 1992, p7 2. William Garner Sutherland DO, Contributions of Thought, 1st Edition, Edited by Adah Strand Sutherland and Anne Wales DO, 2nd Edition, SCTF, 1998 p239 3. Brooks RE and Becker RE, ed. Life in Motion,Stillness Press, Portland, OR, 1997, p 95