Osteopathy [os-tee-op-uh-thee] or osteopathic medicine is an approach to healthcare that emphasizes the role of the musculoskeletal system in health and disease. The first school of Osteopathy was founded in 1892 by Andrew Taylor Still, an Army surgeon in the American Civil War. In the United States an American-trained D.O. (Doctor of Osteopathic Medicine) is legally and professionally equivalent to an M.D. in all 50 states, since their medical education and training is mostly identical.

Outside of the United States, osteopathy has been considered a form of complementary medicine, emphasizing a holistic approach and the skilled use of a range of manual and physical treatment interventions in the prevention and treatment of disease. In practice, this most commonly relates to musculoskeletal problems such as back and neck pain. Osteopathic principles teach that treatment of the musculoskeletal system (bones, muscles and joints) aids the recuperative powers of the body.

In the 20th century, osteopathy in the United States moved closer to mainstream medicine in its philosophy and scope of practice. Although manipulation and other principles of traditional osteopathy are still taught in some form in U.S. osteopathic medical schools, they are used by a small minority of graduates in actual practice.

According to Harrison’s Principles of Internal Medicine, “the training, practice, credentialing, licensing, and reimbursement of osteopathic physicians is virtually indistinguishable from those of allopathic (MD) physicians, with 4 years of osteopathic medical school followed by specialty and sub-specialty training and [board] certification.”[37] DO-granting US medical schools have curricula identical for the most part to those of MD-granting schools. Upon graduation, most DOs attend the same internship and residency training programs as their MD counterparts.

Safety concerns have been raised in relation to manipulative techniques used by some osteopaths. ‘Neck cracking’, i.e. cervical high-velocity low-amplitude thrusting, has received particular attention in the popular media owing to a possible risk of arterial occlusion and consequently of stroke.

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