The osteopathic medical visit There are a number of things a back pain patient can expect from a medical examination by a Doctor of Osteopathy (D.O.). While trained in the principles of osteopathic medicine, not all D.O.s use osteopathic manipulative treatment (OMT) in their practice. Depending on the individual osteopathic physician’s medical specialty and interest, the emphasis of OMT in his or her practice varies considerably. Each patient is advised to check with the individual doctor first to see whether she or he uses OMT. Typical examination First, the doctor will ask for a complete medical history, including specific questions about the history of the back pain episodes and prior treatments. Information that is also important to the osteopathic physician is whether there has been any significant past trauma, falls or accidents, even if they occurred a long time ago. The reasoning behind this is that it is not uncommon for such an event to cause a number of compensatory changes in the musculoskeletal system over time. The pain of today may be the result of the body’s inability to compensate further. The D.O. may order standard tests (e.g. blood and urine) and imaging studies (e.g. x-ray, bone scan, CT scan, MRI, etc.) as part of the diagnosis. The examination, in addition to a targeted neurological and orthopedic assessment, will emphasize a complete structural functional evaluation of the musculoskeletal system. This typically includes: Visual assessment of posture, spine, muscles, balance and gait Physical palpation of the back, legs and arms to assess the quality and motion of tissues and structural make-up Movement of the back, legs and arms, checking for joint restriction and/or pain One goal of the examination is to determine whether there exist one or more relevant somatic dysfunctions which would require treatment. The term "somatic dysfunction" is an accepted diagnosis according to the Hospital Adaptation of the International Classification of Disease. It denotes the impaired or altered function of related components of the somatic (body framework) system, including the bones, joints, muscles and fascia, and related blood vessels, lymph vessels and nerves.