1. The document discusses the differences between osteopathic medicine (D.O.) and other types of doctors like MDs and chiropractors (D.C.s). It emphasizes that D.O.s take a holistic approach and use osteopathic manipulative medicine (OMM) in addition to conventional treatments. 2. Chronic pain is defined as lasting over 90 days, and the document stresses the importance of proper diagnosis to identify the underlying cause. D.O.s are trained to look for causes beyond just symptoms by examining a patient's full history and physical connections between different body parts. 3. The document presents OMM and prolotherapy as two alternative treatment approaches for chronic pain that

1. DO vs. MD vs. D.C.:
MD + SUPER-CHIROPRACTOR + Holistic Philosophy = DO
D.O.!

2. An Osteopathic Perspective:
What Every Pain
Patient Should Know
Mitchell A. Cohn, D.O.

6. Learn 4 things today
1. Who I am and why you might want to listen to me
2. What Osteopathic Medicine is & Why you should
care/know about it:
“D.O.ing Healthcare Better!”
3. Chronic Pain (CP) – What it is and why PROPER
Diagnosis is THE most vital component to resolving
it
4. 2 Alternative approaches to Treatment of Chronic
Pain:
a. Osteopathic Manipulative Medicine (OMM)
b. Prolotherapy

7. Mitchell A. Cohn, D.O
Doctor of Osteopathic Medicine (D.O.)
focusing on treatment of
acute and chronic pain & injuries

8. MY BEST FRIENDS

10. Points:
1. The pain may go away, but your body never forgets.
2. Your life, health, ability to function, sense of well-being can hinge
on a single unexpected event.
3. Why listen to me:
Conventional wisdom?
WRONG!
I Fixed MYSELF without losing weight
THEN I lost almost 100 lbs!

11. One more reason you might
what to learn more about
Osteopathic Medicine and the
treatment of Chronic Pain…

12. Osteopathic Medicine
Who can tell me what an Osteopath is?
European vs. AMERICAN Osteopath?

13. Fun Fact
DO’s = 7% of all US Doctors
MD's 93%
DO's 7%

14. DO vs. MD vs. D.C.:
MD + SUPER-CHIROPRACTOR + Holistic Philosophy = DO
D.O.!

15. Osteopathic ManipulativeMedicine
(OMM) vs. Chiropractic

16. Holism:
“It’s All Connected”

17. Stress

18. CHRONIC PAIN

19. Acute pain often becomes chronic if not
treated properly.
Chronic Pain - 90 days or longer

20. EVERYONE has C.P. at some point in LIFE!
•1 in 2 people CURRENTLY have chronic pain

21. 2 main categories of injury
(recognized by all types of Drs.):
Overuse/repetitive use
Acute damage
© Fredgoldstein | Stock Free Images

22. 2 significant differences between DO’s &
Other Drs. re: Diaganosis & Treatment of
Pain:
1. Tx of Acute injury
most Doctor’s = RICE
MEAT:
- Movement
- Exercise
- Analgesia
- Treatment

23. RICE PREVENTS Healing via
•Fluid mechanics 
TISSUE COMPRESSION
SHRINK VESSELS via cooling 
↑Resistance to Fluid FLOW
o↓FLOW INTO TISSUES:
↓ less nutrition
↓O2
↓White cells
↓removal/eating damaged tissue.
↓rebuilding
= POORER healing

24. o↓FLOW OUT:
lymph or venous compression  Back Pressure
Swelling (edema)
↓ muscle function
↓ waste removal
 Poorer Healing
 Can LEAD to development of CP !!!!

25. MEAT does OPPOSITE of RICE PROMOTES Healing

26. Helps to have DO’s understanding of physiology
of injury & healing.
M.E.A.T. –
It’s not just for meals, anymore!

27. Chronic Pain Diagnosis:
A. General differences:
o MD’s
look at injury
maybe get hx…
more interested in x-ray
o E. Isaacs - 'MD Gone Bad'

28. o GOOD DO
looks at Injury
Hx of injury
A good DO can tell more from hx and PE than MD
can from x-rays and MRI-s
ex. chronic ligament damage won’t show & MD
doesn’t even know about it
and hx of any PRECEDING injuries
Physical Exam for DO completely different than for MD

29. Most Drs:
•Focus on signs & symptoms
ex. weakness/malfunction.
•All Drs. SHOULD be looking for 
causes that are
Ex. IP tightness
oPT/MT  Stretching
oVs. CAUSE: L1-2 somatic dysfunction
treatable.

30. BUT
DO’s look at injuries differently & therefore at PAIN,
differently:
Whole-body connectedness – Ex:
Cranium  sacrum (meninges)  pelvis  knee
foot mechanics
Pebble-in-the-shoe story

31. 4 Examples of CHRONIC PAIN mis-diagnosed & mis-treated
by most MD’s:
•Chronic Chest Pain (Rib) – OMM

32. •Chronic LBP – QL [missed by most D.C.’s, too!]- OMM

33. Chronic “Sinusitis” or “Migraine”

34. Often NO CAUSE ever found – Drs. don’t
know where
to look
 Dx’d w/ “NERVE PAIN” though ‘nerve’
tests are
normal
LIGAMENTS / TENDONS !!
These Ligament injuries NEVER properly
DIAGNOSED & therefore never properly
TREATED!  Chronic Pain

35. Many Dr.’s
•If can’t find cause …
•Fail meds:
there is no cause!
– so … pain meds
“It’s all In your HEAD”

36. GOOD Dr.’s – FIND CAUSE –
Malalignment
Fluid blockage
Pinched Nerve
Weak/injured ligament/tendon

37. What about what OMM alone CAN’T fix?
•PROLOTHERAPY!
•Like MEAT tx,  gets body to HEAL ITSELF !!

38. Fix Chronic Pain??
FIX CAUSE!
via
OSTEOPATHIC MANIPULATION
Nutritional Supplementation, etc.
PROLOTHERAPY

39. Learned 3 things
•What Osteopathic Medicine is
•CP – What it is and why PROPER DIAGNOSIS
is vital
•2 Alternative approaches to Treatment of
Chronic Pain:
1.OMM
2.Prolotherapy
3. M.E.A.T. (bonus!)
•& MUCH, MUCH MORE!

40. If you WANT to LEARN MORE
•OATZA – Survival with the Masters of Health
Fun Fantasy & Fact showing what DO’s can do that
other Dr.’s can’t
Or, go to AmericasPainDetective.com
for a FREE booklet ~
Treatments for Chronic Pain that Actually Work!
& have some FUN!

41. And remember
“It’s All Connected”