Osteopathic Manipulative Treatment (OMT)

Alleviating pain through a hands-on osteopathic approach

“To find health should be the object of the doctor. Anyone can find disease.”

Osteopathic Manipulative Treatment (OMT)

Osteopathic manipulative treatment (OMT) uses specific mechanical diagnosis and applies gentle, low-force, hands-on manipulative techniques to treat patients of all ages. Patients with acute or chronic musculoskeletal injuries and pain of the spine and extremities will benefit from OMT.

What is Osteopathic Manipulative Treatment?

The human body is a complex, adaptive system. The 206 bones, connective and myofascial tissues of the body represent a self-supporting and self-correcting mechanical system with functional properties that emerge from this complexity. 

The sum of the whole is more than the individual function of its parts.

These complex features result in global interactions of the entire system producing “action at a distance” and synergistic phenomena.

When dysfunction arises in this system, a disrupting force may produce its impact either locally or at a distance and produce pain, poor tissue healing, restricted motion, and injury.

Comprehensive osteopathic care is directed at alleviating restrictions in this complex system through utilization of osteopathic manipulative treatment. It is imperative when interacting with such a dynamic adaptive body, to treat beyond symptoms of pain or localized tissue reaction.

Very often, pain is felt in the area of the body experiencing the most difficulty adapting. Skilled sequencing to identify the areas of key restriction are imperative for utilization of osteopathic manipulative techniques to their greatest efficacy.


  • Hands-on, gentle, low force approach
  • Isolates and treats areas of primary stiffness in the spine and the extremities
  • Restores range of motion and flexibility
  • Eliminates cause of pain so the body can heal
  • Facilitates recovery to optimum function and return to activity


Conditions Treated

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Osteopathic manipulative treatment (OMT) uses specific mechanical diagnosis and applies gentle, low-force, hands-on manipulative techniques to treat patients of all ages.

Frequently Asked Questions

OMT uses specific mechanical diagnosis and applies gentle, low-force, hands-on manipulative techniques to treat patients of all ages with acute or chronic musculoskeletal injuries and pain of the spine and extremities.

Effective OMT treatment results in long lasting positive outcomes that do not require maintenance treatment.

OMT is a hands-on approach to diagnose and treat specific joint and musculoskeletal problems by isolating and treating areas of primary stiffness in the spine and the extremities that are the source of pain.

Pain is usually located where the body is experiencing the most difficulty adapting. In many cases, the painful area is compensating for an adjacent area of dysfunction or stiffness.

The stiff (and often pain-free) area does not do its share of the workload, thereby overloading the body parts above, below, or on the opposite side. The area that is struggling to adapt the most usually becomes the symptomatic, painful site.

Many times, other forms of treatment are less effective because they are directed primarily to the painful area. Isolating and treating the parts of the body that are creating the painful imbalance will relieve the overload to the involved areas and eliminate the cause of pain.

Your body will continue to heal long after your formal treatment is over. You will get better and stay better.

The osteopathic examination is a brief hands-on assessment in addition to your medical exam that focuses on identifying the areas of greatest restriction in your body that correlate with your specific painful condition.

In screening your body for key areas of stiffness and restriction, the sequence of treatment and type of OMT technique is then tailored specifically for you.

Since the OMT techniques Dr. Gesik uses are low-force and gentle, they are well tolerated by patients of all ages.

You can sometimes feel “lighter” or “taller” immediately following OMT as the body begins to initially respond to treatment.

The full effects, however, are not immediate. As the body continues to connect and assimilate the changes made during treatment, you may feel achy or sore for the first couple of days.

These symptoms can be alleviated by ice, heat, gentle aerobic activity, anti-inflammatory modulators such as curcumin or fish oil, or non-steroidal anti-inflammatories such as Ibuprofen if needed.

Usually, patients report that they start feeling changes in pain 3-4 days following treatment which can include decreased pain, localization, or migration of pain, which are all common expectations.

The number of compensatory or restrictive layers contributing to pain varies from person to person. Similar to the image of “peeling an onion,” osteopathic manipulative treatment is specific to you.

Starting with the outermost layers, which are often compensatory in nature, we work our way deeper to the root causes, removing areas of restriction along the way.

This individualized approach to personalized treatment is the cornerstone of Dr. Gesik’s approach to osteopathic manipulation as she evaluates and identifies the appropriate sequence and treatment at every visit.

Since we are all unique in how our bodies have arrived at pain, strain, and injury, there is no “standard treatment plan.” As OMT helps restore normal patterns of movement and joint mechanics,

Dr. Gesik will work with you in the formation of an individualized treatment plan supervising your return to functional and recreational activities.

The goal of OMT is short-term restorative treatment, eliminating the causes of pain and stiffness in the body. Most cases will see significant improvement in 4-6 weekly treatments.

Your body will continue to heal after effective treatment is completed. No monthly maintenance visits will be necessary to “keep it working.” Of course, “life happens” with cumulative insults from repetitive movements, compromised sitting posture, and new injuries for which Dr. Gesik is always here for you.

  • Neck and back pain
  • Rotator cuff tendonitis
  • Tennis elbow
  • Carpal tunnel, wrist, and hand injuries
  • Hip pain
  • IT band syndrome
  • Patellofemoral/knee pain
  • Achilles tendonitis
  • Plantar fasciitis
  • Ankle sprains
  • Post-concussive headache
  • Tension headaches
  • Pregnancy related neck and back pain
  • Sports injuries and repetitive stress injuries

All forms of bodywork can be beneficial. Dr. Gesik will collaborate with your preferred healthcare provider to maximize your long-term positive outcomes. 

There are many gifted healthcare providers here in Hawaii. It is not our intention to replace any of these practitioners, rather to be a consultant for short-term, restorative care that will enhance your body’s ability to respond to all forms of treatment, exercise, nutrition, and activity.

Chiropractic manipulation is popular, quick, and often effective for acute musculoskeletal problems addressing “alignment” issues of the spine.  Treatment plans often require multiple visits and maintenance treatment. 

Rather than targeting areas “out of alignment” with high velocity thrust type manipulation and spinal adjustments, OMT will treat underlying causes of pain whether acute or chronic. 

OMT is directed at the source of the problem rather than chasing painful areas or segmental alignment issues and therefore provides longer-term relief, often permanently. 

Since the goal is short-term restorative treatment, OMT does not require maintenance visits.

Orthopedic physical therapy does an excellent job with restoration of range of motion, function, and dynamic strength of injured or painful areas of the body. 

Physical therapists are the experts for rehabilitating post-operative cases of the spine and extremities. 

There is excellent opportunity for collaborative treatment with physical therapists in the community. 

For those patients who do not fully recover with physical therapy, comprehensive OMT examination and treatment will often discover contributing dysfunctions away from the surgical site or injured areas that need to be addressed. 

Eliminating these contributing dysfunctions, will allow the body to heal, complimenting the effectiveness of physical therapy treatment.

Massage therapy is a popular form of bodywork that is enjoyed by patients for both comfort and therapeutic purposes. 

There are many different schools of massage in Hawaii like Shiatsu, lomi-lomi, acupressure, Hilot, and other traditional styles.  Short-term OMT intervention will clear areas of stiffness and dysfunction that contribute to chronic pain and arthritic conditions. 

If ongoing massage therapy is necessary, it will be more effective after OMT treatment for long-term management of chronic conditions.

Dr. Gesik, being an osteopathic physician board certified in family medicine and sports medicine, does not require a referral from your primary care physician.

** You can schedule directly with Dr. Gesik for OMT for any musculoskeletal pain of the spine and extremities. 

She will collaborate with your primary doctor for medical management and submit detailed reports regarding your musculoskeletal diagnosis and proposed treatment plan.  You do not have to change physicians to see Dr. Gesik. 

She will collaborate with your primary care physician to treat any musculoskeletal pain or strain problems you may have. 

Following short-term OMT treatment, you will return to your primary care doctor for your ongoing medical needs.

**Some plans including HMO may require a referral from your primary care provider. 

Please contact your insurance carrier to inquire about referral policies and coverage for OMT under your given plan. 

OMT diagnostic and treatment codes are universally accepted for reimbursement with most insurance companies including HMSA, Medicare, MDX Hawaii, United Health Care, and Cigna.  Referral from your primary care physician is generally not required to receive OMT. **