Speaking of Women's Health
The Speaking of Women's Health Podcast is excited to bring you credible women's health information from host and Executive Director, Dr. Holly L. Thacker. Dr. Thacker will interview guest clinicians discussing relevant women's health topics and the latest news and tips.
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Speaking of Women's Health
Exploring the Benefits of Osteopathic Manipulation
Discover the transformative potential of osteopathic manipulation with our special guest, Dr. Korrie Beverley-Waters from Cleveland Clinic’s Wellness and Preventative Medicine Department.
This episode of the Speaking of Women's Health Podcast dives deep into the holistic approach of osteopathy, offering a fascinating alternative to traditional surgery and medications.
To make an appointment with Dr. Beverley-Waters, please call 216-491-7888.
Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...
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Welcome to the Speaking of Women's Health podcast. I'm your guest host, lee Klecker, the producer of the podcast, and I'm happy to be back in the Sunflower House. We have a new podcast episode today with Dr Corey Beverly Waters, and we will be talking about how osteopathic manipulation can help avoid surgery and medications. But first let me tell you a little bit about Dr Beverly Waters and her professional background. She works in Cleveland Clinic's Wellness and Preventative Medicine Department and she earned her undergraduate degree in biology from St John Fisher College in Rochester, new York. She then went on to Ohio University's College of Osteopathic Medicine in Athens, Ohio, to earn her medical education and I am a OU alumni as well, so walked past that school many, many times, to many classes and go.
Speaker 2:Bobcats. Oh yeah, oh yeah.
Speaker 1:That's where I met my husband too, so we're like Bobcat crazy, yeah. And she then went on and did her residency in family medicine at Summa Health Systems Family Medicine Residency Program in Akron, ohio. And she did another residency in osteopathic neuromuscular let me try that again neuromusculoskeletal medicine at Eastern Maine Medical Center in Bangor, maine, and she sees patients at Cleveland Clinic South Point Hospital in Warrensville Heights, ohio. So welcome, dr Beverly.
Speaker 2:Waters. Thank you, lee, for the introduction, and I know osteopathic neuromusculoskeletal medicine is a mouthful.
Speaker 1:I actually worked on that right before this and I had it. I had it. But, as I mentioned, we're going to talk about today osteopathic manipulation and how it can help avoid potentially future surgery and medications. So I just wanted to start. For our audience out there, what is osteopathy or osteopathic medicine? What is the difference between? You know you're a DO and then we see a lot of doctors who are MDs. So if you wouldn't mind just giving us a little background on that, Absolutely yeah.
Speaker 2:So this is a kind of one of the common questions that I get and we're fortunate here, because of Ohio University's kind of strong presence, that there are a large portion of DOs both in the Cleveland area and kind of all throughout Ohio. But osteopathic medicine in general, or DOs, is basically another alternative way to become a physician in the United States and there are some different practice rights if you're outside of the US, but that's probably outside of the scope of what we're trying to talk about today. About a third of the physician population in the US are actually DOs and a lot of the medical training is very similar to what MDs or allopathic physicians receive. We all go through four years of medical school and all have residencies. Currently, actually all of the residencies that we all attend are all under one system, currently the ACGME, so that's all under one governing body at this point. But the philosophy of a DO or an osteopathic physician is a little bit different. It's more holistic than kind of your average allopathic physician or MD.
Speaker 2:From the very beginning of our medical education we really focus on, you know, considering the body as a whole. So a lot of times, especially in subspecialty medicine, considering the body as a whole. So a lot of times, especially in subspecialty medicine, you'll say, okay, you're just here for cardiology or just here from pulmonology, your lungs, your heart, and things are really kind of individually broken down quite a bit. But at the core, foundation kind of principles of osteopathic medicine is really thinking about how the body functions as a unit. So how are we taking in all of those pieces, whether it be how are you functioning in your home and your day-to-day, what kind of stressors are influencing your symptoms to you know what other conditions you may have. So it's not, you know, so isolated as some patients may experience when you go to other offices.
Speaker 2:But in general, you know, the osteopathic principle is really about that holistic care element and DOs in general also think about how structure and function are interrelated, develops lower back pain because they've been limping prior to their hip replacement for six months, and how those pieces relate maybe even to their pelvic floor and when they start to develop urinary problems. So we're kind of looking at the bigger picture, not just an isolated joint or an area of the body, to try to put those puzzle pieces together. So at the very foundation of DOs or osteopathic medicine, those kind of principles underline any DO that you may interact with, and you know DOs in general can be in a wide variety of specialties. So they could be your primary care doctor, like I'm also board certified in family medicine. They could be your neurologist. They could even be your surgeon, so there are a wide variety of specialties that DOs can be in as well, right?
Speaker 1:And I know many of our women's health fellows, current fellows and fellows that have graduated through Dr Thacker's Center for Specialized Women's Health Fellowship Program, are DOs and go on to be OBGYNs, women's health specialists and all that. So yeah, that's really interesting. Thank you for that background. So let's dive into our topic for the episode, which is osteopathic manipulation treatment, or OMT. If you could tell us what that is and then we'll talk a little bit, dive a little more into you know comparing that to chiropractic care and you know what kind of you know treatment really. You know it's all about and the conditions that it treats.
Speaker 2:Definitely so. Osteopathic medicine or osteopathic manipulative treatment or osteopathic medicine they both have a similar abbreviation, both are listed as OMT, but what we refer to as an osteopathic manipulative treatment is the OMT you generally hear of, and all medical students that go to osteopathic school actually start learning OMT as a first-year medical student. So then it's something throughout the kind of medical education that all DOs do learn, and then some of us choose to subspecialize in it. So the big mouthful of the board, the residency that I attended with the osteopathic neuromusculoskeletal medicine, is to subspecialize in that approach, and how I usually describe it to patients is essentially I'm the body structure doctor, so I'm looking at you kind of head to toe, trying to think about how all these pieces really integrate into the whole and where something maybe an old injury or an old illness maybe still playing a role in what your health and wellness looks like today.
Speaker 1:Okay, so what then does this manipulation treat? Is it everything or is it something specific? Is it pain or are there certain conditions?
Speaker 2:Yeah. So there really is kind of a whole wide variety of things. I would say the most common entry point and kind of the third most common complaint in primary care offices in general is actually low back pain. So we do see a lot of pain-related complaints of any joint really. So if it exists in your body and it hurts you can come see us. But otherwise we also do internal medicine disorder problems.
Speaker 2:So we can help people with, you know, asthma or COPD improve their lung function through improving the kind of connective tissue surrounding the ribs and the diaphragm. We can help people that have chronic constipation or pelvic floor issues. So if someone's having, we see a lot of patients that have urinary incontinence issues, whether it was after they had a child to help assist with realigning their pelvis. We see a lot of obstetrical patients as well having pain, you know, during their pregnancy. So we do really see and treat kind of a wide variety of things TMJ, migraines. We even see pediatric patients for issues with head shape after delivery or if they're having difficulty turning their head or even recurrent ear infections. It can be helpful for.
Speaker 1:Huh, interesting. I just sort of assumed when I was doing my research. Most of it talked only about back pain and kind of manipulating the body and that's it, and so really interesting to know how much more it could do for all ages.
Speaker 2:It definitely and it really is, as I had mentioned before, kind of that holistic approach. So you know, when you come into a visit with me or any of my colleagues here, we're really looking at that 360. So, thinking about how you know your stress is affecting your life, how your diet is affecting things, how your sleep is affecting things, it's not just you know, how is this particular area of your body moving? Well, don't get me wrong, we absolutely do the mechanical assessment, similar to what you may have in many of your other doctor's offices. But you also get, you know, you ask kind of a variety of detailed questions because we're really looking for, you know, the interplay of how you are functioning and how your life is and how it's impacting how you're feeling.
Speaker 1:Yeah, I mean that's it's really great, cause I think what we're focusing now in health in general or at least I know um, in working with Dr Sacker and the speaking of women's health program but it's, it is the whole body. It's not just okay you get migraines, but it's like let's take care of, like, start eating healthier, lose weight if you need to, you know, reduce your stress level, but all these things you know. Exercise, of course, and that's just you know. So it's looking at you, like you said, the big picture. So it's great. So, again, when doing my research, I saw a lot of back pain, you know, being what OMT treats. So I was like, well, what is the difference between going to a chiropractor and getting chiropractic care compared to going to see you know someone for OMT treatment?
Speaker 2:Definitely, and I would say just as a whole, people are just more familiar with chiropractors just being that they're.
Speaker 2:You know that there's a signpost on every street, it seems like sometimes, and so this is actually a question that we get often, because we do do the hands-on treatment, and so what I generally tell patients is, and kind of the foundation of things, is that we are full-fledged physicians, so we have the ability to order imaging or medications if needed and kind of go down that further diagnostic approach where chiropractors don't necessarily have that same training. And then even back to our training piece. You know, we go to medical school and then we have residency where chiropractors also don't do that, and then at the basic kind of foundation of things, there are some treatments that do overlap that chiropractors perform and we do as well. But I would say the other piece that distinguishes us is we usually do techniques that can be more directed sometimes to the muscles or connective tissue or something known as fascia, which is this layer that is a large connective tissue spread throughout our body that really can be a source of a lot of pain in patients.
Speaker 1:Huh, so what is fascia?
Speaker 2:It's a muscle, that's yeah. So fascia is this, it can be dense. So maybe you've heard of plantar fasciitis before. I would say that's kind of the most familiar entry point.
Speaker 1:Everyone has heard of that. I'm a runner so I've had that deal. I've dealt with that a lot, oh yeah.
Speaker 2:So you're very familiar with that. So, uh, and that's just an area in our body where it is the most dense, right at that kind of the aspect of our foot. Um, but fascia itself actually covers all of our muscles and then it covers the muscles in various layers and also connects the muscle kind of down to bone. So just like you know, tend tendons, ligaments or tight muscles there can get tightness or restriction in the fascia that really can pull from a very far away area to influence another spot of the body. So something like your foot sometimes can cause lower back pain or maybe even headaches, depending on how tight that area is.
Speaker 2:Fascia kind of has different patterns in thickness or densities throughout the body where it can kind of pull in certain areas. A lot of times we should see trouble with tightness in fascia, especially in the front part of the neck for people that spend a lot of time at the computer and maybe don't have the best posture when they're at the computer. And so one of the other kind of differences between our approach and chiropractic oftentimes is because we're looking at the fascia, we're looking at that 360 of the body, we're addressing also the anterior structures of the body, just not the spine. So oftentimes, if you think of the neck like a big cylinder, there's kind of lots of tubes within tubes. So if you don't address kind of that front part of the tube and and get that to open up and loosen up, you're never going to improve the back pain or the neck pain.
Speaker 2:Wow, really. So, yeah, yeah, so it's. It's the nice. You know again not to overuse the term holistic, but it really is looking at that whole person, where that major strain or pull is is coming in and how to address that yeah, wow, okay, great.
Speaker 1:major strain or a pull is coming in, and how to address that? Yeah, wow, okay, great. So I guess one of my questions was who would need OMT treatment, you know?
Speaker 2:do you see a certain group of people, more women over men, people with certain conditions? Yeah, so we see all ages and all sorts of conditions, so I would say any of the things that I had mentioned before, kind of any of those populations. I mean we talked about women with pelvic pain or pregnant ladies. Like we said, we see a wide variety of patients for even with, you know, symptoms like MS or other kind of musculoskeletal disorders. I mean, essentially, if what I said now seems like it would apply to you, we will see. We see people with swallowing problems. I mean it's kind of a whole wide variety of complaints that we can address from a more holistic perspective.
Speaker 1:Yeah, Well, I've definitely. I mean I mentioned to you before we went live. But I'm thinking now my fascia is probably where I'm getting all my lower back pain from, and a person who had plantar fasciitis, I think yeah, so I'll probably be seeing you soon, hopefully, if I can get an appointment. We just did a podcast on how to get an appointment quicker and easier, like some inside tips, because it's pretty difficult now for patients to see doctors.
Speaker 2:It can be absolutely yeah, and we at CellPoint do direct scheduling right through our office, so we don't use the central scheduling.
Speaker 1:Oh listeners, that's great yeah.
Speaker 2:Yes, yeah.
Speaker 1:Okay, so can you kind of walk us through maybe what would happen before the treatment and then maybe during your treatment and kind of give us an example of maybe a couple of those conditions and sort of like? You know what would be the before, and then you know when they're at the appointment, yeah.
Speaker 2:So I would say we start kind of with that comprehensive piece, so we go through kind of the history and if there's any trauma, either mental, emotional or physical trauma that may be playing a role in what they're feeling or what brings them in, if they've had any imaging, kind of that review together we walk through that whole process and then really it's quite a thorough exam, anything from something simple like checking your reflexes and the range of motion in the joint to checking for other areas of what we refer to as somatic dysfunction, meaning areas in the body that are just not moving as well as they should be. And then we sit down after that, after we do the exam, and talk about kind of what the treatment plan may look like, for what reason that they're coming in. I would say in general, for most issues I recommend at least three to four treatment sessions, unless it's something that just happened, really suddenly, like oh, all of a sudden I woke up yesterday or the day before I tweaked my back and I can't straighten up, perfect, we can probably take care of that. One visit, no problem. But if it's been something that you've had, you know pain for 20 years and things are, you know, your fascia, your connective tissue, your muscles. There's all this tightness and compensation. Because you've had it for so long. You know that will probably be on the closer end of at least four visits for that scenario.
Speaker 2:And then in general, you know, I just let people know, kind of similar to how we spoke about before. It's a hands-on technique, it's kind of hard to describe If anything causes you pain. If you have any questions as you go along, I always let them know. Just give me a shout. You know, definitely in control of this whole scenario and some of the techniques that we do may be a little bit uncomfortable. But just you know that dialogue is always something that we're kind of constantly going back and forth between about the treatment, because sometimes some discomfort does need to happen in order to get a really tight area released. But in general I would say most of the techniques or hands-on treatments that we do are quite gentle.
Speaker 2:Patients sometimes can experience some new or shifting pains over the next couple of days, sometimes up to a week. As you start to get that fascia, the connective tissue and the muscles realign, it can kind of activate new areas in the body. Maybe that have been what I term as kind of asleep or just not active. So maybe muscles that you've been compensating for for so long. Finally, let's say, your pelvis is released and now you're feeling a new spot in your back just let them know.
Speaker 2:Kind of any of the possibilities are definitely reasonable. So can have worsening pain for a couple of days, you can feel no change or you can feel better. Any of that is acceptable and basically lays the foundation still for progress. And then the other thing I usually do is give patients a few targeted home exercises, depending on what they come in for, just to make sure that they have something that they can do in between our visits and usually it's I try to keep them very reasonable and not too onerous. I don't give people pages and pages targeted home exercises a lot of times yoga-based exercises because it's a fantastic way to start, you know, moving the body and a lot of these patients that have had pain for many, many years. So try to do something nice and gentle to start moving at home.
Speaker 1:And so, how spread out are these? If they do need, say, four treatments because it has been a condition that's been, you know, bothered them for years, how spread out would the visits be, condition that's been, you know bothered them for years.
Speaker 2:How spread out would the visits be? Yeah, I would say the ideal state, and probably what our scheduling state is, is unfortunately a little different. We do have currently outside of myself three other full-time physicians, but we also have other educating responsibilities. So, for example, I'm the director of osteopathic education at South Point, so that hat takes some time away from my clinic time. Ideally, the setup would be you have your initial visit and then you have appointments every two weeks. Realistically, initial visit may be about six weeks or so before you have your follow up, but then after that point, the idea is that you would have a series of visits scheduled, approximately every two to three weeks, Okay, and do most patients then after that sort of say, fourth treatment, they're good, they don't need to see you again.
Speaker 1:Or do you recommend, you know, coming back a year later?
Speaker 2:Yeah, so kind of what I would say. Another difference between us and chiropractors in general is my intent every time I see someone is to try to get them so they don't have to see me again and I always let people know. Hey, that's not personal, but we're trying to get to the root of the issue. So, yeah, it absolutely can be an open door. Life happens. You know, there are lots of, let's say, pitfalls in the day-to-day life that can kind of bring things back around, especially if someone's you know active and they're a runner or they have another child or there's another kind of see them as an intermittent basis. So it absolutely is kind of fluid, but I would say that's kind of an average. The four visits.
Speaker 1:Yeah, and I was mentioning and my mom said this was okay to bring up so for privacy reasons but my mom saw Dr Beverly Waters for some very bad back pain that was going all the way down her leg and she was just, you know, walking, that was sort of her daily exercise and but she said you did wonders for her and she hasn't had to go back, the pain went away. So I know she's really grateful for you.
Speaker 1:Yeah, so it does work now that I'm preaching, but yeah, a success story there. So we talked about the. You said that between visits people can do things at home. Is there anything else they can do at home? Like that's always something I think our listeners are curious about is what can I do at home to prevent sort of pain, especially again, we've talked a lot about the back pain, but you know, what else can they do to their bodies to kind of prevent any chronic pain or you know anything like that that we've talked about.
Speaker 2:Yeah, I would say kind of the analogy that I use in general to encourage people to do more motion or just movement of their body, is using thinking of the tractor rusty tractor in the field.
Speaker 2:You know, if you park the tractor in the field and you don't move the tractor, let's say for a year, it's probably not going to start and won't move.
Speaker 2:Well, it's the same kind of scenario with our body. So moving our body in lots of different ways and I try to recommend that patients find something that they enjoy, patients find something that they enjoy. So a lot of patients recommend, you know, enjoy dancing, yoga, tai Chi, walking for exercise, and the people that are most successful in maintaining their routine is when they find something that works for them. So, or swimming is another, you know, great, fantastic option, especially for people with with chronic low back pain, because you get that benefit of taking a little break from gravity. So I would encourage movement in whatever patients enjoy, and again, I do often and we and we have a great, a lot of great yoga offerings actually that are free through the Cleveland Clinic for chair yoga for patients. Even here at South Point and on main campus they have some offerings that I absolutely recommend for a large majority of my patients as a safe way, by supported in a chair, to start getting some of that motion back in the body.
Speaker 1:Yeah, I'm actually interviewing Judy Barr in a couple months, so she'll be on the podcast. And Judy, she created the yoga program. Is that, am I correct?
Speaker 2:Okay, yes.
Speaker 1:Yeah, so I'm excited to interview her and we'll talk more about yoga and the benefits and kind of you know the different forms of yoga. I used to do yoga. I did that hot yoga, I'm sure there's a name for it but my friend owned a studio so I went to hers and I tell you my back pain was so good. Friend owned a studio, so I went to hers and I tell you my back pain was so good. I, I, I mean I I get up now and it hurts and I'm not that old yet, but and when I was doing yoga I had no pain. It's just right now with my you know my schedule and everything. It's hard to get away and do that and go to a studio. But, yeah, a lot of benefits.
Speaker 2:Yeah, I would say, within that scenario, doing what you can. And that's kind of where I give people the specific home exercise program to say, okay, maybe you can't make it to the yoga studio, but try these three different yoga poses or postures. I think these will be beneficial. So it's kind of that pick, pick five minutes in the day. You know cause often everyone's busy, right we're. We're in a women's health podcast, a lot of mothers, a lot of grandmothers, a lot of responsibilities, a lot of things you're trying to juggle in a day. But even taking, let's say, five minutes for yourself can make a big difference.
Speaker 1:So you can do all those other pieces in your life, Absolutely. I mean, I preach it all the time in my writing for Speaking of Women's Health on this podcast, but I don't do it. You know I don't listen to my own advice. But it's good advice, but you're right.
Speaker 2:You got to try to practice what you preach.
Speaker 1:Right, right. So since we are, you know the topic was how osteopathic manipulation can avoid potential surgery and medication. I have to assume those are a few of the main benefits of the treatment, but what other advantages and benefits would you say that the treatment provides?
Speaker 2:Yeah, absolutely, I would say. People that are looking for a non-pharmacologic or non-pill-based pain management option is kind of where a lot of as an entry point to our practice definitely comes from. Or people that, for example, want to try to delay when they need a knee replacement or a hip replacement or maybe even a spinal fusion, depending on you know what condition they come in and, if that's possible, to try to delay that surgery. And there is a terminology, it's called tensegrity, and essentially the way I describe this is, if you've seen a bridge and you're familiar with the triangle formations on a bridge, that's one of the strongest structures that exist. We have those similar kind of triangles all throughout our body. So even if you have terrible arthritis, if you can restore that support structure via the ligaments, the fascia, the other connective tissue around that joint to try to assist with taking pressure off of that joint, a lot of people can get some pretty significant pain relief.
Speaker 1:Yeah, that's great, and I know a lot of people do try to avoid medication now and not have to rely on that on a daily basis, so I think this could be a good option for many of our listeners out there. Is there anybody who shouldn't get this treatment? Any people who have certain conditions? Are they not candidates, or?
Speaker 2:Yeah, I would say that's kind of where that initial consultation comes into play and kind of what I was alluding to about some of the different spinal conditions. So if they present to us with back pain and we do our exam and there's something very concerning that they may need surgery, we definitely route them that way. But if we can manage them without surgery, we absolutely try to.
Speaker 1:Okay, great, and are there any? You know risks or complications that come with OMT, or you know warnings beforehand?
Speaker 2:Yeah, I would say, outside of just some general soreness and the rare bruising, depending if a patient's on a blood thinner, there's really no significant adverse side effects. Well, that's great, or risk, that is. Yeah, I would say there. Yeah, I was going to say. The one other thing that people may hear about and typically they usually associate with chiropractic care is the like neck cracking. We do also quote unquote crack backs, but they call it high velocity, low amplitude or HVLA is the name of that technique. There is a very rare instance of that causing some blood vessel injury in the neck and in the scenario where a patient has very bad arthritis, that's a technique that we would avoid. So there's lots of other approaches outside of that. You know quote unquote cracking technique that we do for patients that have maybe osteoporosis or osteopenia or any other kind of concerns. There are definitely a whole wide degree of treatment approaches that are more gentle aspect to avoid some of these really potential severe side effects or adverse effects.
Speaker 1:Oh, that's good to know, because I I do know, you know, arthritis is, you know, a condition that at least many of our listeners have, you know, shared with us and I know my own family members. Almost everybody has it after a certain age, so that's good. Is there any sort of wait time to go back to usual activities? Activities If somebody you know, you know, going back to, like their exercise regime or anything like that, do you kind of, or is that encouraged to actually go back to your usual activities after treatment or seeing you?
Speaker 2:Yeah, I would say a lot. A lot of that recommendation definitely is individualized depending on what somebody is coming in for. I would say usually at least I say I usually joke with patients today I don't want you running a marathon today, but tomorrow you know you can go ahead. I say usually the day of treatment I wouldn't recommend anything strenuous. You know people usually feel good. So then they're like well, I cleaned the whole house or you know I ran 10 miles, you name it. And then they kind of overdo it because they feel good, you name it. And then they kind of overdo it because they feel good. So kind of, within that initial day of the treatment, within that 24-hour period, I usually tell people just to go for a gentle walk or kind of do your normal routine, just don't go crazy.
Speaker 1:Makes sense yeah, don't overdo it. I like that some people go home and clean the whole house Like, oh no, yeah, exactly, all right. Well, can you tell us how our listeners can maybe learn more about you and make an appointment with you? Do you have a website we can direct them to or a phone number?
Speaker 2:Yeah, absolutely. You can find my information on the Cleveland Clinic webpage under Find a Physician and then our office phone number itself. This is the direct line. As I mentioned, we don't do. The central scheduling is 491-7888.
Speaker 1:And is that a 440 area code it?
Speaker 2:is a 216.
Speaker 1:Okay, well, we'll put that information in the show notes too for our listeners so it can easily be clicked on and made a phone call to if they're interested in making an appointment with you. But this is really interesting and hopefully we can have you back on to kind of dive even deeper into some other topics around osteopathic medicine.
Speaker 1:Thank you, and thank you to our listeners for tuning in to another episode of Speaking of Women's Health podcast, for tuning in to another episode of Speaking of Women's Health podcast, and we're so grateful for all of your support and hope you will consider supporting the podcast, sharing with others and subscribe for free wherever you listen to podcasts. So thank you again for listening and we will see you all next time in the Sunflower House. Thank you.
