Osteopathic Medicine: We Feel Your Pain

“My doctors are starting to question my back pain,” said Meghan, “They have run a lot of tests and can’t find any reason for my pain.”

Meghan heard about me from another patient and came with a hope that I could help her.

“I’m starting to worry that they’re right and there really is nothing wrong with me,” she explained somewhat despondently.

“Lay down on the table.” I said, “Let’s see what we can find.”

Meghan laid down on her back. I examined her whole body. There were dysfunctional areas that felt “tense” and “stuck” from her feet all the way up to her head. As I get to her upper back, I note that there’s a group of ribs that just will not move.

As I press with my fingers on the one that feels the worst to me, she exclaims, “That’s my pain exactly. You seem to key in on the areas that really hurt. Even places I did not know about. So you don’t think I’m crazy?”

“Of course not,” I reply, “I would be in pain too if I had this.”

One of the unique advantages of osteopathic medicine can offer is the ability to turn one’s hands into finely tuned pain, tension, and problem sensors. Osteopathic physicians learn to feel structural dysfunctions in anatomy. They learn to understand what normal feels like versus abnormal with any tissue or structure they are evaluating. They should learn to do this locally at a particular spot or be able to read a larger global pattern in the body.

This ability really helps osteopathy separate itself as a way to relate to the patient. Having the ability to feel and define a patient’s problem when no one else can is highly important. It helps a person feel like they are being listened to. More importantly, by being able to define their problem, this can make the person feel hopeful there is a solution.

Being able to feel and define the patient’s pain and problem is really important to the physician as well. If the osteopathic physician cannot feel with their fingers what is going on, then they have no way to gauge if they have improved the problem. Having the ability to feel what the pain is caused by, one can also gauge if it has improved. I often know when patients will feel better or not when they get up based on how things have changed during the course of the treatment.

Having that feedback is essential to be able grow and improve one’s skills. Then the treatment can really become customized to the patient. Otherwise, one is just trying shots in the dark hoping that one of the things they do will work and provide relief. There’s no clear way to tell if the treatment has helped. Being able to feel patient’s problems, then one can read the body differently, even if they’re encountering something new.

It was about 6 weeks after Jim had prostate surgery that he came for one of his usual appointments.

“I’m only going to mention this because you have helped me for things in the past that I did not you would be able to help with. Since my surgery, I have not been able to void my bladder completely. I have to use a catheter to get the rest out. If you can help with this, I would be grateful,” said Jim

“I don’t know if I will be able to help, but I’ll see what I can do. Why did this happen?” I asked

“The surgeon was not sure, but he said it probably has to do with the anesthesia. Doing more research, I learned that the surgeons will blame the anesthesiologist when something happens they’re not sure about,” he replied.

So Jim laid down on the table. As part of my examination, I found his bladder was twisted, there was a tremendous dysfunction on the bones and joint the bladder attaches to, and there was a problem at the pelvic floor. So I worked to resolve those problems. As they released, it felt like the anatomy was more correct. When we were done, Jim left unsure of whether or not the changes I made would help Jim.

He returned a month later with his wife. Both were amazed about the improvement.

“My bladder has been significantly better since the treatment. There is nothing else I can attribute the improvement to,” said Jim.

Feeling impressed, Jim mentioned he made it a point to tell the surgeon and his physician assistant 3 times about it. All were followed by awkward silences. Finally after the third time, the surgeon responded with, “We find that those who are proactive about their health, heal much sooner.”

As an osteopathic physician, I’ve been trained to use my hands to sense problems others cannot. This is a huge advantage when helping patients. It gives me the opportunity to quickly place my hands on patients, feel what is wrong no matter what it is, and know if I have made a difference. I am not solely dependent on imaging studies that may or may not show what I can find with my hands. If as a practitioner, you cannot feel the patient’s pain, then how can you know you have actually helped them?