Q: Who May benefit from Osteopathic Manual Medicine (OMM)?
• Musculoskeletal problems, stress, anxiety, poor postural habits, migraines, vertigo, traumatic brain injury, , & PTSD.
• While not a cure, manual medicine is a safe way to mitigate the symptoms of scoliosis, pectus excavatum, hemiplegia, cerebral palsy, muscular dystrophy, ADHD, OCD, PTSD, and autism.
• Neurodegenerative disorders like Parkinson’s disease, multiple sclerosis may make symptoms more manageable, but it does not alter the course of the disease.
• Post treatment Lyme syndrome, POTS, & mold allergy, by balancing the sympathetic & parasympathetic autonomic system.
• Athletes in training
• During pregnancy
• Perinatal care: Treatment after delivery assures that these structures return to their normal relationships preventing problems later on. Newborns are good candidates for OMM. During the birth process they are exposed to stresses which can often be relieved in one or two treatments. This may prevent or reduce serious conditions arising such as torticollis, plagiocephaly, colic, learning differences or reflex and movement dysfunctions.
The gentle rocking, traction, listening to, and augmenting physiologic movements stimulates and refines proprioception that is a crucial sense to physical and cognitive function.
• Acute & chronic pain: Whenever there is pain, there is inflammation. The lymphatic system reduces inflammation. This is the target of many medical treatments like oral & injected steroids & NSAID’s. There are no pain receptors in the body and no pain centers in the brain. We have nociceptors in the body that register when there is tissue injury and the inflammatory response to it that is the healing process. It is the central interpretation that brings to consciousness our perception of pain in the somatosensory area. The messages from the nociceptors in body tissues can be amplified or reduced in the spinal cord and then in a number of other unconscious decision making centers in brain before reaching the somatosensory center. NSAID’s reduce inflammation at a cellular level so less nociceptors fire. Pain medication like morphine don’t suppress pain, but they induce euphoria which alters our perception of pain and how we feel about it making the ‘pain’ more tolerable.
Q: How do D.O.s differ from M.D.s?
A: Both DO’s & MD’s are licensed physicians with a full scope of practice to do procedures, perform surgery, deliver babies, internal and emergency medicine, psychiatry, pediatrics etc in hospitals and clinics across the nation. Both get similar training in all of these through internship, then do a residency that makes us eligible to take board certifications in that specialty.
The only things distinguishing DO's from MD's are the underlying philosophy of osteopathy, and the refined use of touch in manual medicine by DO’s who have done a residency in Neuromuscular Medicine & Osteopathic Manual Medicine.
Allopathic Medicine has no underlying philosophy. Osteopathy is based on the principles of healing outlined on the History page.
Some MD's are becoming interested in learning osteopathic techniques. They are welcome in our post graduate trainings.
Q: What is the difference between a PT & a DO?
A: An osteopathic physician (DO) is a medical doctor with a broader scope of practice that includes diagnosing illnesses, prescribing medication, and performing surgical procedures, while a physical therapist (PT) focuses on rehabilitation through exercise, manual therapy, and movement. Osteopathic physicians use a holistic approach to treat the body as a whole. PT’s often focus on rehabilitation on the affected area to restore function. Both approaches are complementary. They can be synergistic receivied concurrently and sometimes it is better to do one and then the other. Best not to do both, or any 2 hands on treatments in the same day to get the maximum benefit out of both.
Q: How do Osteopaths differ from Chiropractors?
A: Chiropractors (DC’s) graduate from a four-year chiropractic program and are not required to have a post graduate residency. They are licensed to manipulate the spine and connective tissues. Osteopaths complete a four-year medical training before embarking on an internship and residency of at least three years, in hospitals training in Internal Medicine, Surgery, Neurology, Pediatrics, Rheumatology, Psychiatry, Ob/Gyn, and other specialties. An osteopathic medical license allows an unlimited scope of practice. Chiropractors are not medical doctors. Their practice is focused on manipulating the spine and nervous systems. Treatments may be synergistic in the right balance.
Q: Osteopathy in the Cranial Field (OCF)?
A: OCF, or cranial osteopathy, is an approach to the head, developed over a lifetime by William Garner Sutherland DO who was a student of founder A. T. Still DO, MD. Dr Sutherland applied the principles of osteopathy to the structure of the cranium, spine, and their contents developing ways to enhance their functions. It has many applications and is helpful for many conditions. Many of Sutherland’s students have continued to develop and practice this art that is based on complex anatomy and physiology. Craniosacral Therapy (CST) is a simplified version that therapists who don’t have a complete osteopathic training can learn at weekend workshops. It has safe protocols.
Q: What is somatic dysfunction (SD)?
“Impaired or altered function of components of the somatic system, including skeletal, arthrodial, myofascial structures along with related neural, vascular, & lymphatic elements.“ It is diagnosed by palpatory physical exam as tenderness, tissue texture changes, muscle tone imbalance or restricted range of motion. Improvement of these after the treatment are indications of improvement, and that the tissues are receiving better nutrition and waste removal for a healthy recovery. Causes of SD’s may stem from inflammation, trauma & microtrauma, overuse injuries, visceral, autoimmune, or endocrine problems, and or poor postural habits. This model gives a richer platform for a more meaningful approach to diagnosing and treating the whole person.
Q: How does osteopathic treatment differ from massage and bodywork?
A: In addition to the large difference in training and scope of practice, an important aspect that distinguishes osteopathic treatment from the many bodywork approaches is the underlying belief system based on medical knowledge that empowers the actual treatment modality, and the structures they effect. The map is not the territory. It is a model that aids navigation to get around and accomplish tasks. The osteopathic model is built on modern medical anatomy and physiology with the intention of restoring health. Having a more in-depth model, in any form, increases precision of diagnosis & treatment and thus potential for therapeutic success. Also, as bias may limit or enhance outcomes as in the placebo and nocebo effects & responses. Dr Friedman has chosen osteopathy because it combines a simple, applicable philosophy, with a practical model to diagnose and treat based on an ever deepening, palpatory & intellectual understanding of practical anatomy & physiology.
Jackson Friedman DO does not manipulate the spine or force fascial or any other change in tissue. He uses knowledgeably directed touch as medicine to affect physiological responses in the interconnected systems in the body-mind to facilitate healing.
Q: How often do I need a session?
A: Some moderate to severe cases may improve significantly in one to a few treatments. Others take longer. Moderate to severe problems may require weekly visits a few times, then bi-monthly, monthly, and eventually as needed.
Q: How long does a session last?
A: Patients are scheduled an hour apart. The initial visit is getting to know each other. If you fill out the health summary ahead of time there is usually 30 minutes of treatment time of the hour and during the follow-up is about 40 minutes depending on what's needed. The body and mind can only absorb so much at a time. Seeds are sown during the session that facilitates beneficial changes for days to weeks after the treatment. Releasing 30% of the underlying root cause of a problem can be enough that your body can heal more quickly over the next days and weeks. Each visit we take up where we left off unless there was a new insult to the system. As we develop a rapport, depth and effectiveness of the session increases.
Q: What insurance do you accept?
A: Dr. Friedman is a participating provider for HMSA but no longer accepts Medicare or QUEST.
If you have a PPO plan of another insurance in Hawaii, you may be covered, but will need to submit your superbill yourself.
To learn if you qualify, please contact your insurance company, tell them my physician license # is 1397 and ask them:
1. Do I have out of network benefits?
2. What’s my deductible? How much have I met?
3. What percent do you cover?
This will give you an idea of what your out of pocket cost will be.
Q: What are the risks?
A: Although rare, there is a chance of exacerbating symptoms for a short period that is self-limiting. Usually that is due to inflammatory products released by the treatment into the intercellular space that needs to be cleared by the lymphatic system.
Q: How safe is Osteopathy?
A: Osteopathy is a very conservative treatment without the side effects of drugs, or the risks inherent in surgery. It is even more conservative than epidurals or PRP & regenerative medicine, that are conservative and safe as well.
Q: Does Osteopathic treatment hurt?
A: No. We are opening new neurologic patterns built on comfort and trust. Osteopathic treatment by Jackson Friedman, D.O. is gentle and sensitively applied. In this paradigm, any pain reduces gain. Discomfort reflexively inspires guarding that tightens tissue and suppresses the healthy circulation needed to facilitate healing.
Q: Is Osteopathy only for treating pain and disease?
A: No. Dr. Friedman treats athletes, dancers, and other healthy people looking to improve their athletic and proprioceptive capabilities and prevent injuries. Writers, artists, actors, and musicians may also benefit from treatments to enhance their creativity and crafts.
It is beneficial to pregnant mothers before and after delivery.
Newborns, whether vaginal or C-section births may benefit from treatments. In an NMM/OMM residency we treated newborns right after birth and in the NICU.
Q: What to expect during and after a treatment?
A: Wear loose, comfortable clothing and as little make up, perfume, cologne, and jewelry as possible. Also, as little caffeine as possible. Based on your goals and findings on exam, you will lie on a padded table and be gently reminded through comfortable touch how to let down your guard and ‘release the brakes’ that restrict range of motion, breathing, circulation, and appropriate muscle tone. These restrictions impede the body’s innate healing mechanisms and can be associated with underlying psychological and emotional discomfort. Releasing these holding patterns supports optimal health & homeostasis. The results are peaceful experiences offering your body and mind a different perspective that may reshape old self-limiting patterns of how we relate to discomfort and movement patterns. Allowing yourself to go into an altered state near, but not sleep, facilitates resetting of sensory motor feedback loops, enhancing perceptions and self-awareness.
Post treatment experiences vary each time depending on what you need to heal and reach your goals.
Osteopathic treatment has limitless applications. And, it is not a panacea. Given its very low side effect profile, and great potential to help a variety of ailments, it is worth considering for conditions that don’t have any medical red flags first.
Q: Where may I access Osteopathic articles and journals?
A: Use there search engines to view abstracts of articles in areas of your interests:
JOM - Journal of Osteopathic Medicine
JAOAO - American Osteopathic Academy of Orthopedics
JOM Archives - American Osteopathic Association
Remember Andrew Wiel MD’s suggestion we use a sliding scale of evidence: “The greater the potential of a treatment to cause harm, the stricter the standards for proof of efficacy should be.” A treatment with a low side effect profile may not need the scrutiny that one with severe side effects should undergo to prove it is safe and worth the risks. Post treatment experiences vary each time depending on what you need to heal and reach your goals.
Osteopathic treatment has limitless applications. And, it is not a panacea. Given its very low side effect profile, and great potential to help a variety of ailments, it is worth considering for conditions that don’t have any medical red flags before employing treatments with potential side effects ro bad outcomes.