How osteopathic care can steer patients toward better health

Edward Stiles, DO, FAAO (Dist.), has dedicated his career to advancing osteopathic medicine. A graduate of A.T. Still University Kirksville College of Osteopathic Medicine (ATSU-KCOM), he was mentored by leading specialists and pioneered the first hospital-based osteopathic manipulative treatment (OMT) services and Medicare coding system. With decades of leadership at osteopathic colleges, including the University of Pikeville-Kentucky College of Osteopathic Medicine, he continues to champion the profession today.

The following is an edited narrative shared by Dr. Stiles. He shares additional thoughts on the impact of trauma and stress on our health, and he shares practical tips for DOs on how to address trauma-related somatic dysfunction in patients.

Nature vs. nuture

In the first two parts of this discussion, we looked at how adverse childhood experiences and adulthood traumas affect patients physically and how I’ve addressed them over the years. I started to realize that adverse childhood experiences (ACE) impact patients physiologically, often resulting in elevated levels of cortisol, norepinephrine and epinephrine. These effects can continue well into adulthood, predisposing patients to many different health issues in their 60s, 70s and 80s.

This brings us to the age-old debate of nature vs. nurture.

Have we placed too much emphasis on the role our genes play in our health? The concept of allostatic load suggests that factors like diet, substance use, physical activity, sleep, stress management and worldview play a huge role in determining health outcomes. If people eat, sleep, think and manage stress the same way their parents did, it’s no surprise that they develop the same health issues. But is that really genetics, or is it learned behavior? When someone changes their lifestyle and sees health improvements, it suggests that environment and habits, not just DNA, play a major role.

Breaking the cycle

Osteopathic medicine, particularly through the principles of tensegrity and mechanotransduction, gives us a framework to understand how mechanical stress affects physiology and even genetic expression. Research by Donald Ingber, MD, PhD, has shown that cells, tissues and entire organisms function as tensegrity structures, meaning mechanical forces can trigger biochemical and genetic changes. This suggests that interventions like osteopathic manipulative treatment (OMT) can actually influence gene expression and alter a patient’s health trajectory.

The osteopathic principles of A.T. Still, DO, fit right into this understanding. Rather than seeing people as prisoners of their genetic makeup, osteopathic medicine provides them with tools to improve their health by focusing on lifestyle and mechanical influences.

In Kentucky, for example, we see high rates of cancer, chronic obstructive pulmonary disease (COPD) and diabetes. We know now that improving lifestyle habits can bring the rates of these chronic diseases down. By shifting the conversation away from genetic fatalism, we can give patients hope, showing them that with regular OMT and lifestyle changes, we might be able to dramatically improve their personal health potential.

The perfect storm

Somatic dysfunction affects circulation, autonomic regulation, ribcage mechanics, lymphatic circulation, ventilation and venous circulation. When combined with poor lifestyle choices, it creates a perfect storm for chronic disease. Osteopathic care, by addressing mechanical dysfunction, lifestyle factors and disease process, can offer a highly effective approach to long-term personal health potential realization.

Osteopathic physicians can approach emotional and psychological trauma-related somatic dysfunctions in a variety of ways. First, by taking a holistic approach to treatment, DOs treat the whole person, not just the symptoms. It is important to recognize how lifestyle, stress and environment impact health.

Trauma-informed care

Physicians must also understand emotional and psychological trauma’s effects on the body. Trauma can impact circulation, sympathetic and parasympathetic function, ribcage mechanics, venous and lymphatic circulation, and overall physiological stress responses.

Osteopathic physicians can use OMT to relieve mechanical stress in tissues, potentially trigger positive epigenetic changes and enable normal body mechanics and nervous system function. These methods can improve patient empowerment. The osteopathic perspective helps patients take charge of their health, offers hope through a whole-body treatment approach, encourages lifestyle changes that support healing and teaches stress management techniques.

Additionally, it’s vital to complete a comprehensive assessment. This includes ensuring that patients are “expressing the emotional garbage out,” i.e., talking through their stress and trauma with a professional or at the very least a trusted friend or family member. We also need to make sure we evaluate sleep patterns, lifestyle habits, emotional outlook and mechanical dysfunctions.

The path to patient empowerment

The goal is to empower patients to take control and realize their personal health potential by addressing trauma’s physical effects through a holistic, patient-centered approach. By integrating lifestyle changes, OMT and tensegrity-based principles, osteopathic medicine provides a powerful and hopeful path to better health.

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