Osteopathic Manipulative Treatment (OMT): What It Treats and What to Expect
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is osteopathic manipulative treatment (OMT)?
Osteopathic manipulative treatment (OMT) is a hands-on therapy in which a trained physician uses gentle pressure and manipulation to ease pain in muscles, fascia, connective tissue, joints and bones. It is most often used for lower back pain, neck pain and migraines. Mild soreness for a day or two is common, but severe pain is not normal. [1]
What the research says
OMT eased nonspecific low back pain across randomized trials. A review of 15 randomized trials found moderate-quality evidence that OMT reduced pain and improved daily function in both acute and chronic nonspecific low back pain, measured 3 months after treatment. (Franke et al., BMC Musculoskeletal Disorders, 2014) [2]
Back pain during and after pregnancy also improved. Across 8 trials (5 in pregnancy, 3 after birth), OMT had a significant medium-sized effect on pain and function in pregnant women (moderate-quality evidence) and a significant moderate-sized effect in postpartum women (low-quality evidence). (Franke et al., Journal of Bodywork and Movement Therapies, 2017) [3]
The evidence is strongest for muscle and joint pain. An overview of 9 systematic reviews covering 55 trials and 3,740 participants found promising evidence for low back pain, neck pain and chronic non-cancer pain, but limited and inconclusive evidence for headaches, irritable bowel syndrome and children's conditions; most reviews reported no adverse events. (Bagagiolo et al., BMJ Open, 2022) [4]
Key takeaways
OMT is a hands-on treatment, most often given by doctors of osteopathic medicine (DOs). [1]
It targets mechanical pain caused by structural imbalance in muscles, fascia, connective tissue, joints or bones. [1]
Lower back pain, neck pain and migraines are the most common reasons people try it. [1]
Mild soreness for a day or two is normal; severe pain is not. [1]
Most people return to usual activities within a day or two. [1]
Who performs osteopathic manipulative treatment?
Osteopathic manipulative treatment is most often performed by doctors of osteopathic medicine (DOs), although medical doctors (MDs) with specialty training can also provide it. [1]
DOs are fully licensed physicians. They practice in every medical specialty, and OMT is part of their training. [1]
DOs take a whole-person approach. That's why your provider asks about your overall health and lifestyle, not just the area that hurts. [1]
What conditions can osteopathic manipulative treatment help?
Osteopathic manipulative treatment is used mainly for mechanical pain, and most people seek it for lower back pain, neck pain or migraines. [1]
It may also help during pregnancy and, possibly, in some infants. [1] Doctors also use OMT as a tool to help diagnose and prevent disease. [1]
Area | Conditions OMT may address |
Spine and head | Lower back pain, neck pain, migraines |
Breathing | Breathing issues |
Digestion | Bowel issues such as irritable bowel syndrome (IBS) and constipation |
Long-term pain | Chronic pain, including fibromyalgia and arthritis |
Muscles and joints | Musculoskeletal problems such as carpal tunnel syndrome |
Women's health | Pregnancy-related problems and gynecological issues |
Injuries | Sports injuries and repetitive stress injuries |
Source: [1]
For more on the conditions above, see our guides to back pain, neck pain, migraine headaches, irritable bowel syndrome, constipation and carpal tunnel syndrome.
How does osteopathic manipulative treatment work?
Osteopathic manipulative treatment works by using the hands to correct structural imbalances that cause mechanical pain in muscles, fascia, connective tissue, joints and bones. [1]
The intended benefits include: [1]
Addressing structural problems in the body
Improving circulation
Supporting the body's ability to heal itself
Easing tight muscles and joint stiffness
What happens before an OMT session?
Before an OMT session, your provider asks about your symptoms and your daily life, including sleep, activity, diet and mental health. [1]
Next comes a physical exam. Your provider examines your body by touch. [1]
In some cases, your provider may order imaging, such as an X-ray or MRI, before treatment begins. [1]
What happens during an OMT session?
During an OMT session, you sit, stand or lie on an exam table while your provider applies gentle pressure and manipulation to specific areas of your body. [1]
For some techniques, your provider may ask you to breathe in a certain way. [1]
Some movements may feel awkward or unusual. They shouldn't cause severe pain. [1]
What are the common OMT techniques?
Osteopathic manipulative treatment includes seven common techniques: [1]
Balanced ligamentous tension
Cranial osteopathy
Diaphragm techniques
Lymphatic pump
Muscle energy
Myofascial release
Rib raising
What should you do after an OMT session?
After an OMT session, drink plenty of water, take a short walk and avoid rigorous activity for 24 hours. [1]
It's common to feel sore for a day or two. Some people feel tired after treatment, while others feel energized. [1]
After OMT | What's typical | What to do |
First 24 hours | Soreness, tiredness or feeling energized | Drink water, take a short walk, avoid rigorous activity |
Day 1–2 | Soreness easing | Return to usual activities |
Before exercise | — | Check with your provider before starting or resuming exercise |
Soreness lasting more than a few days | Not expected | Call your provider |
Source: [1]
Is osteopathic manipulative treatment safe?
Osteopathic manipulative treatment techniques are considered safe. [1]
Minor soreness is the most common side effect, and small bruises can occasionally appear. [1]
Severe pain is not a normal side effect of OMT. [1]
How long does it take to recover from OMT?
Most people return to their usual activities within a day or two of osteopathic manipulative treatment. [1]
Talk to your provider before you start or resume an exercise routine. [1]
You may need several treatments over a few weeks. [1]
How is OMT different from chiropractic care and physical therapy?
Osteopathic manipulative treatment is a holistic, hands-on approach, while chiropractic adjustments often use force to treat a specific injury and physical therapy uses exercise to improve function and mobility. [1]
Feature | OMT | Chiropractic adjustment | Physical therapy |
Main approach | Holistic, hands-on | Often uses force | Exercise-based |
Usual focus | The whole person and structural imbalance | A specific injury | Function and mobility |
Source: [1]
Learn more in our guides to chiropractic adjustment and physical therapy.
When should you call a doctor after OMT?
Call your provider if soreness after osteopathic manipulative treatment lasts more than a few days. [1]
Also contact your provider if you have severe pain, because severe pain is not a normal side effect of OMT. [1]
Conclusion
Osteopathic manipulative treatment is a hands-on, whole-person approach to mechanical pain in the muscles, joints, bones and connective tissue. It is most often used for lower back pain, neck pain and migraines, and research supports its use for low back pain, including during and after pregnancy. [1][2][3]
A session starts with questions and a physical exam, uses gentle pressure and manipulation, and is usually followed by a day or two of mild soreness. [1]
Ready to take the next step? If pain in your back, neck or joints is affecting your daily life, ask your doctor whether OMT could fit into your treatment plan. Then explore our back pain guide and sciatica guide to understand your options before your appointment.
FAQ
What is OMT?
OMT, or osteopathic manipulative treatment, is a hands-on therapy that uses gentle pressure and manipulation to ease pain in muscles, fascia, connective tissue, joints and bones. Doctors of osteopathic medicine (DOs) most often perform it.
Who can perform osteopathic manipulative treatment?
Osteopathic manipulative treatment is most often performed by doctors of osteopathic medicine (DOs), who are fully licensed physicians trained in OMT. Medical doctors (MDs) with specialty training can also provide it.
What conditions does OMT treat?
OMT is most often used for lower back pain, neck pain and migraines. It may also address breathing issues, bowel issues such as IBS and constipation, chronic pain such as fibromyalgia and arthritis, carpal tunnel syndrome, pregnancy-related and gynecological problems, and sports or repetitive stress injuries.
Does osteopathic manipulative treatment hurt?
Osteopathic manipulative treatment shouldn't cause severe pain, although some movements may feel awkward. Mild soreness for a day or two afterward is common.
What are the side effects of OMT?
The main side effects of OMT are minor soreness and, occasionally, small bruises. Severe pain is not a normal side effect.
What should I do after an OMT session?
After an OMT session, drink plenty of water, take a short walk and avoid rigorous activity for 24 hours. Check with your provider before starting or resuming exercise.
How many OMT sessions will I need?
You may need several OMT sessions over a few weeks.
Is OMT the same as seeing a chiropractor?
OMT is not the same as chiropractic care. OMT is a holistic, hands-on approach, while chiropractic adjustments often use force to treat a specific injury.
Is OMT covered by insurance?
Many insurance plans cover OMT when a physician provides it as part of a medical visit, but coverage varies. Check with your insurer before your appointment.
Can OMT help back pain during pregnancy?
OMT may ease low back pain during pregnancy, and providers use gentle techniques. Tell your provider you are pregnant before treatment.
Related Reading
Chiropractic Adjustment: What to Expect, Benefits, and Risks explains what happens during a chiropractic adjustment and its risks.
Understanding Lower Back Pain: Causes, Symptoms, and Solutions covers common causes of low back pain and ways to treat it.
Neck Pain: Symptoms, Causes, Diagnosis, and Treatment explains common causes of neck pain and treatment options.
Myofascial Release Therapy: How It Works, What It Treats, and What to Expect explains a hands-on technique that loosens tight fascia.
References
Cleveland Clinic. Osteopathic Manipulative Treatment (OMT). Cleveland Clinic. Last updated January 22, 2025. https://my.clevelandclinic.org/health/treatments/9095-omt-osteopathic-manipulation-treatment
Franke H, Franke JD, Fryer G. Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2014;15:286. PMID 25175885. https://doi.org/10.1186/1471-2474-15-286
Franke H, Franke JD, Belz S, et al. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis. J Bodyw Mov Ther. 2017;21(4):752-762. PMID 29037623. https://doi.org/10.1016/j.jbmt.2017.05.014
Bagagiolo D, Rosa D, Borrelli F. Efficacy and safety of osteopathic manipulative treatment: an overview of systematic reviews. BMJ Open. 2022;12(4):e053468. PMID 35414546. https://doi.org/10.1136/bmjopen-2021-053468
Medical disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always talk to a qualified healthcare provider about your symptoms and before starting any new treatment.
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