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What Can I Expect?
When encountering a new patient, a thorough history is essential, including any trauma history, and especially with younger patients, a birth history as well. A physical exam then provides more essential information. An osteopathic structural exam will be a significant part of the physical, as not only does the physical body reflect injury or postural problems, but also through neurohormonal mechanisms can give pertinent information of a disease process affecting internal organs (asthma, heart conditions, GI problems, etc.). Neurologic or orthopedic testing may be needed, as well as postural and gait evaluation.
Very gentle palpation of the fully clothed patient gives information of how myofascial strains are distributed throughout the patient’s body, such that a tension through an affected organ or body part can be accessed using an area that is less painful. This can be quite helpful when working with problems that are very painful to touch, such as acute rheumatoid arthritis.
Putting together the information of the injury or disease, an initial picture of how to make contact with the self-corrective mechanisms to the body structure forms. What is important is to not take a preconceived idea and force it into the body, but rather to observe how the patient’s body responds to input and follow its dictates. This can take surprising directions, such that manipulation of a collar bone or the diaphragm can be curative for hand numbness and swelling, or that working on the sacrum can resolve headaches. Also, it is not uncommon for me to be lightly touching the patient’s body and just observe it sorting itself out.
After the first or second treatment, a gentle and passive corrective stretch, or a strengthening exercise may be given to hasten the healing process and allow the patient to control or resolve symptoms on their own should they return. Supplements to reduce inflammation or otherwise provide needed nutrition may be suggested. Occasionally, medications such as say a muscle relaxant for an acute muscular problem may be prescribed, acupuncture needles may be used, or injections of saline water into trigger points may be done. Bloodwork or imaging may be ordered. All of this is done with the aim of helping obtain necessary information, and towards respecting and helping your body to find its way back to health.
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