Book Review  |   May 2008
Somatic Dysfunction in Osteopathic Family Medicine
Author Affiliations
  • Michael A. Seffinger, DO
    Western University of Health Sciences College of Osteopathic Medicine of the Pacific Pomona, Calif
    Associate Professor of Osteopathic Manipulative Medicine
Article Information
Book Review   |   May 2008
Somatic Dysfunction in Osteopathic Family Medicine
The Journal of the American Osteopathic Association, May 2008, Vol. 108, 239-267. doi:
The Journal of the American Osteopathic Association, May 2008, Vol. 108, 239-267. doi:
Somatic Dysfunction in Osteopathic Family Medicine, edited by Kenneth E. Nelson, DO, and Thomas Glonek, PhD, is a landmark publication in osteopathic medical literature. In the more than 50-year history of the American College of Osteopathic Family Physicians (ACOFP), this book represents the first time the College has commissioned a peer-reviewed, multi-expert treatise explaining how somatic dysfunction affects patients and how osteopathic physicians can treat them using uniquely osteopathic methods. 
The text is adequately referenced with current evidence-based literature, and numerous photographs display techniques of osteopathic manipulative treatment (OMT). Twenty-two osteopathic physicians adept at applying osteopathic principles and practice—including OMT—serve as contributing authors. To enhance content validity, the editors consulted a total of 28 peer reviewers. 
The editors, both professors at Mid-western University/Chicago College of Osteopathic Medicine (MWU/CCOM) in Downers Grove, Ill, are well known and widely respected in the osteopathic medical profession. Dr Nelson is a fellow with the ACOFP and the American Academy of Osteopathy (AAO). He embodies the aspirations and missions of both these organizations and has unified their efforts with this outstanding text. He is also a noted author who has cowritten numerous osteopathic medical research articles with Dr Glonek—several of which have been published in JAOA—The Journal of the American Osteopathic Association.1-3 
Dr Glonek has mentored and collaborated with many osteopathic physicians during the past 30 years in various research endeavors, and he has published more than 30 articles related to osteopathic medicine. Along with coauthors Sandra L. Sleszynski, DO, and William A. Kuchera, DO, Dr Glonek received the coveted George W. Northup, DO, Medical Writing Award for their 2005 original contribution in the JAOA on the Outpatient Osteopathic Single Organ System Musculoskeletal Exam Form series.4 Furthermore, in recognition and appreciation of his career-long dedication to fostering the growth and development of the osteopathic medical profession through his dedicated service, expert mentoring, prolific research activity, and scientific publications, the AAO awarded Dr Glonek with honorary lifetime membership in 2005. 
Osteopathic medical students, residents, and physicians can sometimes find themselves perplexed regarding how best to apply OMT in the management of a wide array of clinical conditions. By focusing on the diagnosis of somatic dysfunction—the key indication for using OMT—this text guides the reader through evaluation and treatment in each of seven patient populations: psychiatric, pediatric, female, surgical, athletic, geriatric, and terminally ill. In addition, the text clearly describes applications of OMT to manage somatic dysfunction in patients with 15 clinical conditions: otitis media, temporomandibular joint pain, upper or lower respiratory tract infections, hypertension, congestive heart failure, gastrointestinal problems, thyroid disease, Parkinson disease, functional vasomotor hemiparesthesia syndrome (Larson's syndrome), fibromyalgia or chronic fatigue syndrome, chronic pain or headache, back pain as a result of short-leg syndrome or postural decompensation in the sagittal plane, and scoliosis. 
Osteopathic philosophy and principles of patient care are espoused in the initial chapters of the book, setting the tone for the patient-oriented approach to clinical problems used in the rest of the text. The basic science rationale for application of OMT in each patient population and clinical condition is presented with clarity. References in these chapters include pertinent, peer-reviewed osteopathic medical literature, including studies from scientific journals around the world. The entire spectrum of evidence-based medical literature is incorporated in the references, including randomized clinical trials, case series and cohort studies, practice guidelines, and expert panel–consensus documents. 
Management plans presented by the editors focus primarily on the role of OMT. However, in some chapters (eg, those focusing on athletes and patients with hypertension, thyroid disease, and Parkinson disease), appropriate recommendations for pharmacologic and surgical interventions, laboratory and radiologic tests, and nutrition and exercise education are also addressed. 
Clinical scenarios highlight application of the book's content. Abundant photographs of OMT procedures facilitate reader comprehension and practical clinical application. The recommended techniques of OMT are described with easy-to-understand, numbered sentences. This format allows practitioners to prop the paperback text open to the pictured OMT procedure and learn to perform the technique by following the numbers. 
Each chapter in the book is unique, insightful, and instructive. For example, the chapter on psychoneuroimmunology serves to bridge theoretical osteopathic constructs with scientific data in a concise and clear manner, bringing the reader up-to-date with 144 references from the scientific literature. Taken together, the various chapters help the reader comprehend the great breadth and power of the primary tenet of osteopathic medicine—the patient is a dynamic functional unit of body, mind, and spirit. 
A bonus to this publication is the inclusion of chapters on documentation and coding. Expert advice and guidance in these matters is adeptly provided by Douglas J. Jorgensen, DO, and Raymond T. Jorgensen, MS, both of whom are certified professional coders and leaders in the osteopathic medical profession on issues related to billing. 
Drs Nelson and Glonek have been prominently involved in developing standardized osteopathic medical records for more than a decade. The late John S. Denslow, DO, renowned professor at the Kirksville (Mo) College of Osteopathic Medicine and Surgery (now Kirksville College of Osteopathic Medicine-A.T. Still University), challenged the osteopathic medical profession in the 1940s through 1970s to develop standardized terminology and medical records. One of his later students, Albert F. Kelso, PhD, continued this charge as professor at the Chicago College of Osteopathic Medicine (now MWU/CCOM). There, Dr Kelso mentored Dr Sleszynski, among others, in the development of a standardized medical record to assist the osteopathic medical profession in improving patient care and research endeavors. As members of the AAO Louisa Burns Osteopathic Research Committee (LBORC), of which Dr Sleszynski was chair, Drs Nelson and Glonek participated in creating the first Outpatient Osteopathic SOAP (Subjective, Objective, Assessment, Plan) Note Form. 
As a long-standing member and current chair of the LBORC, and as a trustee of the AAO, I can attest to the fact that the historical details of the initial LBORC meetings and the current status of the standardized osteopathic medical records are recorded here for the first time—by those responsible for developing these valuable tools, which allow osteopathic physicians to document methods of patient evaluation and treatment in osteopathic medicine. Emphasis is placed on precise standardized terminology for the osteopathic structural examination and use of OMT. In the final chapter of this book, Drs Sleszynski and Glonek present the entire group of standardized SOAP note forms copy-righted by the AAO and recommended by the ACOFP and American Association of Colleges of Osteopathic Medicine. 
I highly recommend this book for all osteopathic physicians, as well as for anyone else who is interested in understanding the clinical applications of osteopathic principles and practice, the clinical value of somatic dysfunction diagnosis, and the rationale for using OMT in varied patient populations. This book is also valuable for describing, in general, the clinical conditions encountered in primary care. 
 Edited by Kenneth E. Nelson, DO, and Thomas Glonek, PhD. 532 pp, $52.95. ISBN 978-1-4051-0475-3. Philadelphia, Pa: Lippincott Williams & Wilkins; 2007.
Nelson KE, Sergueef N, Glonek T. Recording the rate of the cranial rhythmic impulse. J Am Osteopath Assoc. 2006;106:337-341. Available at: Accessed April 4, 2008.
Licciardone JC, Nelson KE, Glonek T, Sleszynski SL, Cruser DA. Osteopathic manipulative treatment of somatic dysfunction among patients in the family practice clinic setting: a retrospective analysis. J Am Osteopath Assoc. 2005;105:537-544. Available at: Accessed April 4, 2008.
Nelson KE, Sergueef N, Lipinski CM, Chapman AR, Glonek T. Cranial rhythmic impulse related to the Traube-Hering-Mayer oscillation: comparing laser-Doppler flowmetry and palpation. J Am Osteopath Assoc. 2001;101:163-173. Available at: Accessed April 4, 2008.
Sleszynski SL, Glonek T, Kuchera WA. Outpatient Osteopathic Single Organ System Musculoskeletal Exam Form series: validation of the Outpatient Osteopathic SOS Musculoskeletal Exam Form, a new standardized medical record. J Am Osteopath Assoc. 2004;104:423-438. Available at: Accessed April 4, 2008.