Traditional Osteopathic Manipulation

Osteopathic manipulative treatment (OMT) is a comprehensive set of manual techniques originating from osteopathy founded by A.T. Still in the late 19th century. Major techniques include soft tissue manipulation, myofascial release, muscle energy technique, counterstrain, articulatory technique, high-velocity low-amplitude thrust (HVLA), cranial osteopathy and visceral manipulation.

Theoretical principles include the body as a unit, structure-function reciprocity, self-regulating mechanisms and the role of somatic dysfunction in disease. Mechanisms supported by evidence include neuromuscular reflex modulation, fascial mobilization, improved local circulation and lymphatic drainage. Cranial osteopathy and visceral manipulation remain controversial with limited high-quality evidence.

Best evidence supports OMT for non-specific low back pain, mechanical neck pain, tension-type headache, mechanical musculoskeletal dysfunction and selected functional GI conditions as adjunct. Contraindications include osteoporosis with high fracture risk, vertebral instability, malignancy in the manipulated area, vertebrobasilar insufficiency and acute infection. In Turkey, osteopathic manipulation is regulated within MoH Traditional and Complementary Medicine framework.