After three of Andrew Taylor Still’s children died of spinal meningitis in 1864, the midwestern healer turned against mainstream medicine. Eschewing drugs and surgery, Still gravitated toward the wellness offerings of his era, dabbling in magnetic healing and hydrotherapy, before outlining a philosophy of his own. Drawing from the teachings of his Methodist-preacher father and his own experiences farming on the frontier, Still argued that the body was a self-healing machine. When physical, psychological, and spiritual afflictions interfered, a doctor’s job was to gently return a patient to homeostasis, usually through hands-on manipulation of the spine. Still called this new discipline osteopathy.
While allopathic, or medical, doctors can trace their lineage back to Hippocrates and ancient Greece, osteopathy is a uniquely American tradition, comparable to jazz, says Wolfgang Gilliar, the dean of osteopathic medicine at Touro University, in Nevada. One in five Americans has never heard of osteopathic doctors, according to the American Osteopathic Association, but they are a substantive presence in health care. About 16 percent of medical residents are now graduates of osteopathic schools, and D.O.s have quietly come to account for 11 percent of all physicians in the United States. While M.D.s may specialize in ever more complicated fields, many D.O.s are proud generalists, and they’re more likely to serve patients’ most basic health needs as primary-care doctors. They are especially prevalent in rural settings, but one is also in the White House: In 2018, President Donald Trump selected the osteopathic doctor Sean Conley as his physician.
Today, osteopathic manipulative medicine consists of dozens of manual techniques—many of them also employed by massage therapists, chiropractors, and physical therapists. There’s high velocity, low amplitude, or HVLA, a pretzel of trust in which a doctor wraps their arm around a curled-up patient to deliver a quick, popping thrust. Strain/counterstrain, which involves holding a patient’s aching joint in a pain-free position, is so gentle that it can feel like nothing at all. D.O.s also do soft-tissue work, including kneading and stretching; lymphatic techniques, such as pumping a patient like a Shake Weight at 100 beats per second to encourage drainage; and myofascial release, a subtle but sustained pressure on irritated trigger points.