What Is an Osteopathic Doctor?

Osteopathic medicine is a branch of medicine that focuses on a holistic approach to treating patients. Osteopathic physicians consider the whole person when diagnosing and treating medical conditions. They believe that the body has the ability to heal itself, and they use a variety of hands-on techniques to help facilitate this process.

Whereas traditional orthopedists focus primarily on structural changes to anatomy (disc rupture, tendon tear), osteopaths focus on function. How is a knee functioning in the context of the lower limb? Are there symptoms in a knee that relate to a problem in a foot or a hip? Is a back pain related to scar tissue or adhesions in the abdomen or pelvis from a previous inflammatory condition or surgery?

History of Osteopathy

Osteopathy was founded by Andrew Taylor Still in the latter part of the 19th century after the Civil War.

Dr. Still was a medical doctor who was distraught at the loss of his wife and three children from spinal meningitis. He spent the rest of his life studying the human body and trying to find alternative methods for treating disease. The focus of osteopathy, as he called it, was on the musculoskeletal system. Dr. Still tried to relate structure and function and adhere to the belief that the body has the capacity to heal itself.

Osteopathy utilizes different types of manipulation to restore function. These include muscle energy, myofascial, craniosacral and visceral manipulation. The ultimate goal of treatment is always to identify what has been impaired and to restore its function. Osteopaths are body mechanics. The presence of pain usually follows the loss of function. As function improves, the pain diminishes and ultimately disappears in the patient.

The Osteopath Advantage

There is no joint or part of the body that functions in total isolation. Muscle groups cross anatomic regions, linking different areas. The neck connects to the shoulder and midback via the trapezius muscle and the sacrum and coccyx to the shoulder via the latissimus dorsi. Why should we ever assume that pain in the low back, neck or hip is caused by an issue at that particular anatomic location? There is always a myriad of influences that affect how any specific joint or region actually functions. The location of pain is usually only the tip of the iceberg, one part of a layered puzzle.

Examination of one isolated area where an individual has symptoms and not relating that region to the rest of the body is removing a problem from context and often leads to poor results. This is further compounded by reliance on radiographic or MRI imaging of a region rather than relating the imaging results to a clinical evaluation of the entire body. Osteopaths do just that. They examine the total patient and try to relate the specific symptoms to the function of the entire body as a total entity.

An important aspect of osteopathic medicine is to carefully identify the health elements that are affecting a patient and to address them all, as they may interrelate in ways that may not initially be clear, but that affect the well-being of the patient.

As San Francisco osteopathic doctors, we listen to patients as this is the only means to make a complete and correct diagnosis and obtain meaningful therapeutic results. Looking at an MRI scan is no substitute for taking a thorough multi-system history and complete physical examination. Being told someone has back pain and basing decision making solely on a scan leads to poor, often unsuccessful, treatment. The osteopathic medical approach is the absolute antithesis of what the traditional medical approach has become in the 21st century.

D.O. Doctors – Doctors of Osteopathic Medicine

Drs. Irène & Robert Minkowsky are San Francisco osteopathic physicians trained in the diagnosis, treatment, and prevention of disorders, injuries and diseases of the musculoskeletal system. For over 30 years they have included osteopathic manual therapy (OMT) in their approach and specialize in osteopathic medicine and the nonsurgical treatment of painful musculoskeletal conditions, spine disorders, and sports injuries.

The musculoskeletal system is very complex and includes joints, ligaments, muscles, tendons nerves and blood vessels, all surrounded by fascia. All of these elements must be addressed for the successful resolution of a problem.

How D.O. Doctors Diagnose

Jean Pierre Barral, a French osteopath, developed a technique called listening. Whenever the body struggles with a problem of balance – imbalance, tensions are created. Through training, an osteopathic doctor is able to detect where these abnormal tensions lie in the body. These are the most critical areas that require treatment, as they are usually the source of a problem. The use of this technique is particularly helpful in longstanding problems in which multiple compensatory layers have been created and current symptoms are often far removed from the original source of a patient’s problem.

As San Francisco osteopathic doctors, Drs. Irène and Robert Minkowsky use this technique in their patient evaluation, often helping them unravel difficult cases where a patient has been previously seen by multiple physicians without success.

How D.O. Doctors Treat

A thorough comprehensive evaluation precedes an individualized treatment program with an emphasis on restoration of musculoskeletal balance, control of pain (principally nonpharmacologic) and recovery of function. Success stems from being thorough and methodical in the approach.

One treatment approach in osteopathic medicine is osteopathic manipulative treatment (OMT). This is a hands-on technique that involves manipulating the muscles, joints, viscera or nerves and blood vessels to improve overall function and alleviate pain. OMT can be used to treat a variety of conditions, including neck and back pain, coccyx pain, sciatica and nerve pain, headaches and facial pain and digestive issues. Many patients find relief from their symptoms after just a few sessions of OMT.

Emphasis is also placed on preventive care. Osteopathic physicians focus on helping patients make healthy lifestyle choices to prevent illness and disease. They recommend dietary changes, exercise programs, and stress management techniques. At the Physicians’ Back Institute, great emphasis is placed on a therapeutic home exercise program to address the postural deficiencies and muscle imbalance that often lead to altered body function.

Osteopathic medicine offers a unique and comprehensive approach to healthcare that can benefit patients in many ways. By treating the whole person, rather than just focusing on symptoms, osteopathic physicians can help patients achieve better health and well-being. At the Physicians’ Back Institute, Drs. Irène and Robert Minkowsky have been practicing osteopathic medicine for over 30 years. They recognize that every patient is unique and tailor treatment specifically to each individual.

Osteopathic physicians focus on the whole person, rather than a collection of independent parts. For osteopathic doctors and back specialists, the goal is to promote the body’s self-healing tendency and to try to restore balance and equilibrium in the musculoskeletal system.

As San Francisco osteopathic doctors, we use different types of visceral and cranial manipulation in our treatment approach. This includes treating bones, joints, ligaments, visceral structures, vascular structures and different parts of the nervous system. The approach is very gentle and is always coupled with a therapeutic home exercise program focused on restoring muscular function and balance.

Conditions We Treat

  • Back Pain
  • Neck Pain
  • Thoracic Pain
  • Rib Pain
  • Coccydynia (tailbone pain)
  • Disc Herniation
  • Sciatica
  • Piriformis Syndrome
  • Headache and Migraine
  • TMJ and Facial Pain
  • Neuralgia / Neuropathy
  • Peripheral Joints (shoulder, hip, knee, ankle)
  • Spinal Stenosis and Other Spine Medical Conditions
  • Facet Arthritis
  • Post-Surgical Pain
  • Repetitive Strain Injury
  • Overuse Training Injuries
  • Scoliosis
  • Sports Training Injuries
  • Functional Gastrointestinal and Genitourinary Disorders (heartburn, GE reflux, IBS, Pelvic Pain)
  • Tendinitis