Osteopathic Manipulative Medicine (OMM)
with Dr. Tess Ish-Shalom, DO
Well Life Medicine offers Osteopathic Manipulative Medicine appointments with Tess Ish-Shalom, DO, a board-certified family medicine physician who is focusing her practice at WLM on osteopathic evaluation and treatment.
Dr. Ish-Shalom sees patients of all ages for focused OMM care. Treatment is individualized based on each patient’s symptoms, health history, age and comfort.
Osteopathic physicians (DOs) are taught that the structure of the body has a direct impact on the function and healing. Osteopathic Manipulative Medicine (OMM) is a way to restore the body’s ability to heal itself by moving muscles and joints. It is a hands-on approach that is used to treat a variety of medical conditions. It considers how the body’s muscles, joints, connective tissues and movement patterns may contribute to pain, restricted motion or reduced function.
Please note: OMM is a focused service and does not replace regular primary care. Patients receiving OMM at Well Life Medicine must maintain a separate primary care provider for preventive care, medications, chronic disease management and other routine healthcare needs.
During an appointment, Dr. Ish-Shalom may evaluate areas of tenderness, muscle tension, restricted movement or changes in tissue texture. Depending on the patient’s needs, treatment may include:
- Gentle pressure or stretching
- Soft-tissue techniques
- Guided positioning
- Muscle resistance techniques
- Myofascial techniques
- Carefully controlled movement of a joint
- Other age and condition appropriate osteopathic techniques
What conditions might OMM be used for?
OMM may be considered as part of a treatment plan for symptoms involving the muscles, joints and movement of the body. Some of the conditions that may benefit from OMM include:
- Acute or chronic back and neck pain
- Acute or chronic limb pain
- Chronic headaches including TMJ
- Whiplash or sports related injuries
- EDS or chronic pain coditions
- Restrictions and discomfort of the rib cage
- Chronic constipation
- Chronic pelvic pain
- Round ligament, pelvic and low back strain during and after pregnancy
- Mood disorders may benefit from OMM
Not every condition or patient is a good candidate for OMM. The first appointment with Dr. Ish-Shalom will include an interview and evaluation. At that point a treatment plan will be recommended, which may include OMM, further treatment by your primary care provider, physical therapist, specialist, or a combination of these.
How is an OMM visit different from primary care?
Primary care provides comprehensive, ongoing healthcare. This includes annual examinations, preventive screenings, vaccinations, medication management, treatment of acute illnesses and management of chronic conditions such as diabetes or high blood pressure.
An OMM appointment is a focused visit addressing a particular concern, usually involving tension, pain and lack of movement. It typically includes a targeted medical and musculoskeletal evaluation and, when appropriate, hands-on treatment.
Although Dr. Ish-Shalom is a board-certified family medicine physician, her role in these appointments is focused on OMM. Seeing her for OMM does not establish her as your primary care provider.
OMM is one part of healthcare. It is not intended to replace the screenings, exams, and medications recommended by your primary care clinician. Instead, it is intended as a complement to standard treatment.
OMM can be a useful treatment option for some patients, but it does not fix every condition and does not guarantee improvement. It may be used alongside medications, exercise, physical therapy and other medical treatments.
OMM does not replace appropriate diagnostic testing, medication, surgery, specialty care or emergency treatment when those services are needed. Patients should continue following the treatment plan established by their primary care provider and other healthcare professionals.
Frequently Asked Questions
What should I expect during my first appointment?
Dr. Ish-Shalom will review your current concern, relevant medical history and previous treatments. She will perform a focused examination that may include observing posture and movement and evaluating muscles, joints and areas of tenderness or restricted motion.
If OMT is appropriate, treatment may be performed during the same visit. Treatment is not automatic; additional evaluation or a different type of care may be recommended.
Do I remain clothed during treatment?
Yes. OMM is generally performed while you are clothed. Please come dressed in comfortable, loose-fitting clothing that allows you to move easily.
Does OMM hurt?
Treatment is intended to remain within your comfort level. Some areas may already be tender, and patients can occasionally experience temporary soreness, stiffness or fatigue after treatment. Please tell Dr. Ish-Shalom immediately if a technique feels uncomfortable.
Is OMM appropriate for children and older adults?
Dr. Ish-Shalom sees patients of all ages. The evaluation and techniques used are adjusted for the patient’s age, size, medical history and individual needs.
Is OMM the same as chiropractic treatment or massage?
No. There can be some overlap in hands-on techniques, but OMM is performed as part of medical care by a licensed physician. Doctors of Osteopathic Medicine complete medical school and physician residency training and can evaluate a patient’s symptoms within the context of their overall medical history.
How many appointments will I need?
There is no standard number of visits. Some patients may need only one or two appointments, while others may benefit from a longer treatment plan. The recommended frequency will depend on your condition, response to treatment and treatment goals.
If OMM is not producing meaningful improvement, Dr. Ish-Shalom may recommend changing the treatment plan or following up with another healthcare professional.
Will insurance cover OMM?
In many cases, Well Life Medicine can bill health insurance for an OMM visit and medically appropriate treatment. However, coverage varies by insurance plan, diagnosis and individual benefits.
Copays, coinsurance and deductibles may apply. An office evaluation and the OMT procedure may also be billed as separate services when appropriate. Insurance billing is not a guarantee of payment. Patients should contact their insurance company or Well Life Medicine before the appointment if they have questions about coverage.
Do I still need a primary care provider?
Yes. All patients receiving OMM services should maintain a separate primary care provider.
Your primary care provider remains responsible for preventive care, routine examinations, vaccinations, medication management, chronic disease care and coordination of your overall healthcare.
Should I stop my medications or other treatments?
No. Continue your medications, physical therapy and other treatments unless the healthcare professional managing that treatment tells you to make a change. OMM may complement other care but should not replace prescribed treatment without medical guidance.
Is OMM appropriate for everyone?
Not necessarily. Certain health conditions or injuries may make some techniques inappropriate. Please tell Dr. Ish-Shalom about your complete medical history, medications, pregnancy, recent surgery, osteoporosis, fractures, blood-thinning medication or other significant health concerns.
She will determine whether treatment is appropriate and which techniques may be safely used.
Can OMM treat an emergency or urgent medical condition?
No. OMM appointments are not a substitute for urgent or emergency medical care. Call 911 or seek immediate medical attention for a medical emergency.
Where can I learn more about OMM?
Schedule an OMM Appointment
If pain, stiffness or restricted movement is affecting your daily activities, an osteopathic evaluation may help determine whether OMM is an appropriate part of your care.
Schedule an OMM appointment with Tess Ish-Shalom, DO, at Well Life Medicine.
“Such a good experience! Very attentive, and it felt personal, not like I was just another patient.”
Clinic Hours:
Monday-Thursday 8:00 AM – 6:00 PM
Friday 9:00 AM – 5:00 PM
or by appointment
West Salem Clinic
1174 Cornucopia St. NW
Suite 240
Salem, OR 97304
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South Salem Clinic
1610 12th St. SE
Salem, OR 97302
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Hillsboro Clinic
256 SE 2nd Avenue
Hillsboro, OR 97123
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Woodburn Clinic
693 Ray J. Glatt Circle
Suite 200
Woodburn, OR 97071
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All three of our clinic locations are designated as Tier 5 Patient Centered Primary Care Homes (PCPCH) through the Oregon Health Authority (OHA). Our Hillsboro location has also been awarded the PCPCH Health Equity Designation. Read more about what this means here.
