It does appear that many doctors are either not well-trained in how to conduct a thorough biomechanical exam or, do not take the time for such, especially with regard to spine-related conditions. Dr Leifheit's osteopathic medical training, his field of specialization, and his 30+ years experience help him to elicit critical elements of the history of a problem, recognize abnormal and/or restricted motion, and make a more specific diagnosis that allows more effective treatment.
Osteopathic Manipulative Medicine (OMM) can utilize a variety of manual treatment methods (direct and indirect techniques) to address musculo-skeletal problems, but can also offer approaches that better define--and treat--conditions which contribute to chronic and/or recurrent musculo-skeletal complaints (indirect / postural treatment).
A DIFFERENT PARADIGM
The human / vertical spine is rather unique in the animal world. The force of gravity acting on this vertical spine, given the variety of postures it conforms to, creates a combination of stresses that can lead to common problems and conditions.
The osteopathic biomechanical exam identifies regions of the vertical spine with reduced or altered mobility. Treatment techniques--by the physician AND by the patient--have been developed to restore physiologic motion to these affected areas and to address the muscle-guarding response that often accompanies musculo-skeletal maladies.
Problems relating to the functioning of the vertical spine in the presence of gravitational stress is understood better by considering the concept of "Force vs. Form closure" (see References: A. Vleming). This fundamental concept describes variables contributing to stability--or lack thereof--of the vertical spine, given the various postures our spines generally assume.
We are routinely subjected to the force of gravity in various postures over our entire lives. Interventions that fundamentally reduce that stress in our more common postures can be helpful in the long-term management--and prevention--of musculo-skeletal problems (see also References: R. Irvin, Reduction of Scoliosis Using a Heel Lift"). Knowledge about--and prudent use of--orthotic regimens can aid in reducing contributors to side-bending stresses associated with degenerative conditions and chronic pain. Such an approach can be important in preventing painful conditions from developing.
PRINCIPLES OF OM AND OTHER DISCIPLINES
Osteopathic Medicine (OM) contends that living beings are generally self-healing and it is the doctor's duty to identify those parts that are not working well/functioning and do something to remove that as an obstacle to health.
Osteopathic Manipulative Medicine (OMM) attempts to identify bio-mechanical and structural issues that may have functional consequences. In this way, OMM is "holistic" in its approach to musculo-skeletal maladies, attempting to identify--and treat--conditons that may seem innocuous or trivial, but which may contribute to cumulative trauma or overuse-injury disorders over years / decades.
Principles of OM have much in common with contemporary disciplines such as Functional Medicine (FM), which has the main goal of identifying underlying causes of disease, and then taking a systematic approach to addressing it.
FM holds high regard for patients being actively involved in the therapeutic relationship, which is indeed necessary for most musculo-skeletal conditions to be successfully managed. Dealing with "flexion stress" using extension stretches (done repetitiously--by the patient), or symptomatic scoliosis, using stretches and orthotics (to fundamentally reduce side-bending stresses), or muscle contracture syndromes--by prudent exercises followed by specific stretches--all require diligent effort on the part of the patient for there to be a positive change in functionality--and for ther to be a more successful outcome.
OM and Chiropractic Medicine (CM) share the view that a properly functioning spine is critical to health. CM became a separate discipline from OM in the late 1890s, focusing on "the spinal lesion", but also embracing nutrition and specific regional dysfunctions as part of its approach to treating disease.
OM exemplifies a practice of medicine that routinely incorporates many basic ethical principles upon which modern medicine is grounded: doctors should treat appropriately and do good for the patient (beneficence) and not do harm (by over-treating--nonmalfiesance). The patient deserves to be educated on their condition (informed consent) and what they can do to fundamentally help themselves and avoid dependency on practitioners to maintain their health (autonomy).
TEACHING AS A SERVICE
Conveying useful information to you about your condition deserves to be an important element of your visit to a physician. It does appear that this important and empowering service to the patient is often neglected in the average doctor-patient encounter.
Dr. Leifheit is committed to spending time to explain your condition or problem and the necessary steps and/or choices to treat it.
For conditions that cannot be cured or completely resolved, methods will be described to lessen your pain, increase your mobility, reduce aggravation, and enhance your quality of life.
Dr Leifheit's office is not large enough to allow space for practicing Physical Therapists (PTs), but he has a close working relationship with many clinics in West Seattle, and can and does refer to PT clinics in the Puget Sound area.
Depending on your condition and the length of time needed to treat it, PT may be helpful to promote more rapid resolution of your injury, show you methods of stretching to address muscle group contracture, or work with you to develope an exercise regimen to prevent muscle atrophy or deconditioning.
Insurance plans will generally insist on a written prescription for PT and timely re-evaluation by Dr. Leifheit.