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About Osteopathy Assessment


An initial assessment with an Osteopathic Manual Practitioner typically lasts one hour, which usually allows some time for treatment as well. Most Osteopaths work in a well-heated private office. Following an interview, a patient is usually asked to disrobe to their underwear or bathing suit so that as much of the body as possible is revealed. This exposure allows the Osteopathic Manual Practitioner to best utilize his or her senses of observation and palpation. During subsequent treatments, disrobing may not be necessary.
The osteopathic assessment is directed toward understanding the patient's complaints and determining the causes of those complaints. The Osteopathic Manual Practitioner listens to both the patient's story as well as the body's story.
The interview begins with obtaining a list of the issues that the patient has sought help for, such as relief from pain, stiffness, tiredness, poor posture, or an overall sense of disease. (The word disease originally meant “a loss or deprivation of ease.”) Then a chronological history covering various categories is taken. The history includes accounts of trauma, such as accidents, injuries, fractures, surgery, falls, and dentistry. Conditions include illnesses, headaches, and syndromes. Childbirth and pregnancy issues are considered, as are general health concerns and the effects of stress and stressful situations. Frequently, nutrition, sleep, and exercise habits are also reviewed.
In many cases, the patient has multiple complaints and has experienced multiple occurrences of the above-mentioned conditions. The recounting of all these incidents and symptoms allows the Osteopathic Manual Practitioner to begin to piece together the underlying factors that are contributing to the patient's complaints.
Building on the initial interview, the Osteopathic Manual Practitioner next begins the physical assessment of the patient. The Osteopathic Manual Practitioner uses his or her eyes to observe, and his or her palpation to sense the condition of the body, tissues, or systems. Through observation, the Osteopathic Manual Practitioner assesses the patient's standing posture, distribution of weight, preferential movement patterns, and evidence of congestion, inflammation, restriction, or protection. While still standing, the patient is asked to perform a series of simple movements, each directed toward determining the nature of specific elements of function.
The Osteopathic Manual Practitioner then begins to palpate the patient—first while the patient stands, then sits, and finally while lying at rest. Initially the patient is able to detect the intent of the Osteopathic Manual Practitioner's testing procedures. As the assessment progresses, the patient's perception of the Osteopathic Manual Practitioner's touch fades as the Osteopathic Manual Practitioner begins to palpate the body in a more subtle manner.
Combining the patient's history with the results of the assessment, the Osteopathic Manual Practitioner can develop a carefully structured treatment plan, which is explained to the patient. Once the patient has understood and consented to the plan, the treatment can begin.