1. What is the difference between a D.O., an osteopath, and an osteopathic physician?

These terms may describe the same person, so they are often just differences in terminology and emphasis. In the U.S., D.O. (Doctor of Osteopathic Medicine) is one of 2 degrees that qualifies a person to become a licensed physician (the other is M.D.).  Because of this any D.O. can be called an “osteopathic physician”, or simply a physician.

All D.O.’s are trained in medical school in the basics of osteopathic manipulative treatment, just as they are trained in the other basic practices of medicine, including obstetrics, pediatrics, psychiatry, and surgery.  Some D.O.’s will specialize in osteopathic manipulative medicine (OMM) also referred to as neuro-musculoskeletal medicine (NMM).  We sometimes call them “traditional osteopaths”, or just osteopaths for short.

Most doctors that practice osteopathic manipulative medicine are specialists – it is the primary or sole focus of their medical practice.  In addition, there are many primary care D.O.s who offer some level of OMM treatment as part of their more general practice.  Less frequently, a D.O. in a specialty field such as neurology, orthopedic surgery, or physiatry may offer OMM treatment as well.

Occasionally, you may encounter a practitioner who trained outside of the U.S.  These people hold Diplomates of Osteopathy;  unless they also hold a M.D. degree, they are not licensed physicians.  These practitioners are also often referred to as osteopaths in their home countries.

2. What is the difference between cranial osteopathy and craniosacral therapy?

Physicians who practice cranial osteopathy are fully licensed doctors who specialize in osteopathic manipulative medicine (OMM) diagnosis and treatment.  During four years of osteopathic medical school, D.O.’s receive extensive training in anatomy, physiology, neurology, orthopedics, and other core areas of medicine.  In addition, all D.O.s have an initial minimum foundation of over 400 hours training specifically in OMM, plus elective training, and they must pass several board licensing exams. D.O.’s must complete an internship and often finish residency training in any medical specialty and/or in OMM. Cranial osteopaths then complete extensive post-graduate training in this sub-specialty of the field, with an emphasis on the autonomic nervous system and what is known as the primary respiratory mechanism – the inherent motion of the central nervous system, cerebrospinal fluid, the surrounding connective tissue, and its manifestations throughout the body.

There is no standardized training or certification that a person must complete before calling him/herself a craniosacral therapist;  craniosacral therapists are non-physicians who have taken at least one 25 hour class in craniosacral therapy.  Craniosacral therapy is a highly simplified protocol derived from cranial osteopathic principles. Most craniosacral therapists are massage therapists, and therefore are not licensed medical professionals.

3. What is the difference between osteopathy and chiropractic?

There are a few key differences between osteopaths and chiropractors.

Traditionally, chiropractic theory has emphasized the impact of the spinal nerves on functioning of the body, and therefore focused on treating the spinal part of the skeleton. In contrast, osteopathic medicine emphasizes treatment of the muscles, bones, connective tissue, and joints of the whole body, because of the effect on the blood vessels, lymphatics, and both peripheral and central nervous systems throughout the entire person, including the autonomic nervous system.

Osteopaths are licensed physicians.  Physician licensure includes training in a full spectrum of medicine, from outpatient and clinics, to surgery, emergency medicine, intensive care and other acute pathology.  This allows us to appropriately identify if and when a more intensive treatment regime might be needed, and to manage osteopathic treatment in the context of complex medical situations.

Most, although not all, chiropractors focus on high-velocity, low amplitude adjustments (“cracking”). This is one of the many techniques learned by osteopathic physicians.  Some osteopaths employ high velocity manipulations as part of their treatment when appropriate;  others rely solely on more gentle manipulations to achieve the treatment goals.

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