What We Do

What is Osteopathy?

There are two kinds of physicians that practice medicine in traditional medical clinics and hospitals in the United States: allopathic physicians, and osteopathic physicians. Allopathic physicians have the title of “M.D.” and osteopaths have the title “D.O.” You will find both working side by side in medical settings everywhere.

Osteopathic medicine is a distinctive form of medical care founded on the philosophy that all body systems are interrelated and dependent upon one another for good health. This philosophy was developed in 1874 by Dr. Andrew Taylor Still, who pioneered the concept of “wellness” and recognized the importance of treating illness within the context of the whole body. In our opinion, an osteopathic evaluation is just a very detailed way to evaluate the movement and function of the musculoskeletal and nervous systems of the body. It involves the extensive use of palpation and range of motion testing of the muscles and joints of the body.

Osteopathic physicians use all of the tools available through modern medicine including prescription medicine and surgery. They also incorporate osteopathic manipulative medicine (OMM) into their regimen of patient care when appropriate. OMM is a set of manual medicine techniques that may be used to diagnose illness and injury, relieve pain, restore range of motion, and enhance the body’s capacity to heal.

 

What is somatic dysfunction?

Somatic dysfunction is the impaired or altered function of bodily structures. The osteopathic evaluation is focused on identifying areas of the body in which the muscles, bones and nerves “are not playing well with each other”. During an osteopathic based exam, the examiner is looking for:

1) Range of motion asymmetries between sides of the body or corresponding body parts

2) Loss of motion of the joints

3) Tissue texture abnormalities in the soft tissues surround the joints

The physician uses techniques such as layer-by-layer palpation and intersegmental range of motion testing to make the diagnosis. Diagnosis usually requires only the use of the physician’s hands and fingertips, though instruments can be used to detect a diminished range of motion.

The hallmark of a musculoskeletal somatic dysfunction diagnosis involves the detection of a “restrictive barrier” related the structure in question. The language of “barriers” refers to the point at which a structure cannot move further in a given direction. For example, a natural “physiologic barrier” of the arm represents the farthest that a person can naturally move their arm before it cannot be comfortably moved further. The “anatomic barrier,” then, is how far the arm can be pushed or pulled by an outside force before the arm becomes physically injured. A “pathological” or “restrictive” barrier represents the shortened range of motion to which the arm is confined because of an injury, spasm, or some other somatic dysfunction. The goal of treatment, then, is to restore the arm’s range of motion (or that of whatever structure is in question).

Other types of somatic dysfunctions may include occlusions or mutilations of vasculature or lymphatic vessels, which can impair cardiovascular or lymphatic circulation. This may also occur secondary to organ pathology, a factor which theoretically allows the detection of visceral dysfunction by examining surface structures.

Somatic dysfunction and dysfunctions can accumulate over time and led to pain. OMT attempts to restore normal function and break a vicious cycle that can develop in many unfortunate patients. A return to normal physiological status both in the spinal tissue and the organ tissue generally ensues except when complicated by the presence of major infection or significant physical trauma. The clinical picture will vary from patient to patient, but the phenomena are based on sound neurological principles.

 

What is Osteopathic Manual Therapy?

OMT is a variety of different techniques that attempt to treat somatic dysfunction. They include, but are not limited to:

1. Muscle Energy Techniques
2. High Velocity, Low Amplitude (HVLA) thrusts
3. Counterstrain
4. Myofascial release
5. Functional Indirect
6. Cranial Osteopathy

 

What is Prolotherapy/C-fiber Neurolysis?

Prolotherapy is a type of injection. First, it is important to understand what the word prolotherapy itself means. “Prolo” is short for proliferation, because the treatment causes the proliferation (growth, formation) of new ligament tissue in areas where it has become weak. Ligaments are the structural “rubber bands” that hold bones to bones in joints. Ligaments can become weak or injured and may not heal back to their original strength or endurance. This is largely because the blood supply to ligaments is limited, and therefore healing is slow and not always complete. To further complicate this, ligaments also have many nerve endings and therefore the person will feel pain at the areas where the ligaments are damaged or loose. Tendons are the name given to tissue which connects muscles to bones, and in the same manner tendons may also become injured, and cause pain.

Prolotherapy uses a dextrose (sugar water) solution, which is injected into the ligament or tendon where it attaches to the bone. This causes a localized inflammation in these weak areas which then increases the blood supply and flow of nutrients and stimulates the tissue to repair itself. This does nearly the opposite of a what a steroid injection does (blocks the immune system by decreasing blood flow). Steroid injections can be harmful and are associated with rupture of tendons and in the case of tennis elbow, a worse long term outcome (British Medical Journal September 2006)

Historical review shows that a version of this technique was first used by Hippocrates on soldiers with dislocated, torn shoulder joints. He would stick a hot poker into the joint, and it would then miraculously heal normally. Of course, we don’t use hot pokers today, but the principle is similar—get the body to repair itself, an innate ability that the body has. Prolotherapy has been studied for many different conditions, but research has been hampered by a lack of funding (no money in selling dextrose). A recent review article in the peer reviewed journal Physical Medicine and Rehabilitation looked at the evidence and concluded that prolotherapy may be helpful in treating chronic low back pain and osteoarthritis, is clearly effective in tendonopathies/ tendonitis.

The injections may be useful for many different types of musculoskeletal pain, including arthritis, back pain, neck pain, fibromyalgia, sports injuries, unresolved whiplash injuries, carpal tunnel syndrome, chronic tendonitis, partially torn tendons, ligaments and cartilage, degenerated or herniated discs, TMJ and sciatica. The response to treatment varies from individual to individual, and depends upon one’s healing ability. Some people may only need a few treatments while others may need 5 or more. The average number of treatments is 4-6 for an area treated. Once you begin treatment, we can tell better how you are responding and give you an accurate estimate of treatment course.

 

What is PENS?

Percutaneous Electrical Nerve Stimulation is a pain reduction technique that involves the insertion of acupuncture needles into the soft tissue. The needles are inserted to a depth of 1-2 cm at the nerve or trigger points serving the area of pain. Wire leads are attached and a small electrical current is passed through the inserted needles. This current disrupts normal pain signals by stimulating local nerves. Over time, this stimulation can result in a decrease in pain.

PENS is similar, in concept, to Transcutaneous Electrical Nerve Stimulation (TENS). Instead of the needle’s precise placement, TENS uses adhesive pads that are placed on the skin around the area of pain. Also, PENS treatments differ from acupuncture where the placement of needles is based on specific theories regarding energy flow in the human body. In PENS, the location of stimulation is determined by proximity to the pain rather than acupuncture theories of energy flow.

The use of PENS can be an integral part of a comprehensive pain reduction/ management treatment. It does not preclude other pain management techniques. It usually requires a series of treatments to be effective. At Albemarle Center for Health and Rehabilitation, if deemed appropritate, treatment begins with three PENS sessions, one to two weeks apart. PENS treatments have proven successful in a wide range of pain issues.

 

What is Pilates-based Rehabilitation?

We use a Stott Pilates approach. It is a contemporary approach to the original exercise method pioneered by Joseph Pilates. It incorporates modern exercise principles, and applies proven and accepted practices in biomechanics, rehabilitation and athletic performance enhancement. Stott exercises are designed to restore the natural curves of the spine and rebalance the muscles around the joints. This involves placing more emphasis on pelvic and scapular stabilization, and integration of al the parts of the body into one. Preparatory exercises and modifications allow the technique to be appropriate for many different body types and abilities, making it applicable to sport-specific training and everyday life Wether performed on a mat or specialized equipment, application of the follow biomechanical principles will ensure the realization of maximum benefits from pilates exercises: breathing, pelvic placement, rib cage placement, scapular movement, and head and cervical spine placement.