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

  • Medical history and conventional physical exam
  • Osteopathic structural exam
  • Osteopathic medical diagnosis
  • Osteopathic treatment

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History and Physical Exam

Before treatment can begin, it is important to take a thorough medical history, including a detailed description of traumatic events.  The osteopathic physician is particularly 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 and compress,  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, chronic use injuries, inflammatory disease processes, surgeries, dental procedure, and mental/emotional stressors.

The conventional physical exam is then used to assess specific medical conditions, symptoms and overall health as indicated in the history. It may include vital signs, a neurological exam and evaluation of cardiovascular, pulmonary, digestive and other systems as needed.

Structural Exam

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, and the quality of motion, 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 often relieved to know that their symptoms finally make sense.


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 blend into one another, since as the 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.  Almost all patients, however, feel a distinct change following the treatment

Though osteopathic treatment is very gentle, patients can occasionally experience some discomfort during certain stages of the treatment, or even 1 or more days later. When this occurs, it is simply a part of the healing process. As the treatment progresses, the discomfort subsides.

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Physicians practicing osteopathy in the cranial field will work anywhere on the body, and they may find it particularly 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.  All osteopathic physicians apply osteopathic principles in treatment. The styles of treatment in which these principles are applied vary from physician to physician.

Results depend upon many factors. Most significant are the body’s inherent vitality (ability to heal), the history of other insults to the body (e.g., illness, toxins, trauma, etc.) and the severity and 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, and everyone can benefit from a treatment that improves the functioning of the body, but it not always enough to address the presenting complaint. For some patients it might be necessary to include other types of treatment. For many, cranial osteopathy is “the solution” to their problems, often when more conventional medical treatments have failed.


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