How Structure and Function Are Interconnected in Osteopathic Medicine

One of the core principles of osteopathic medicine is that structure and function are intimately connected. This means that when the body’s structure is altered—even slightly—its function can be impacted across multiple systems. If a joint is restricted, posture is unbalanced, or fascial tissues are tight, the body must compensate in other areas. Over time, these compensations may lead to pain, reduced mobility, or dysfunction in not only the musculoskeletal system but also the circulatory, respiratory, digestive, and nervous systems.

Everyday Strains, Lasting Effects

Many of these structural imbalances arise from routine activities in daily life. For example:

• Prolonged sitting—common in desk jobs or long commutes—can lead to tightening of the hip flexors and reduced spinal mobility, particularly in the lower back and pelvis.

  
  

• Forward head posture from extended screen time or phone use shifts the head’s weight forward, placing excessive strain on the neck, shoulders, and jaw, and potentially contributing to headaches or TMJ dysfunction.

  
  

• Favoring one side of the body—such as predominantly using the right hand for tasks like writing, reaching, or carrying—can lead to asymmetrical muscle development and joint strain, especially in the shoulder and upper back.

  
  

While these changes may seem minor at first, they can shift the alignment and movement dynamics of the entire body. Left unaddressed, they may contribute to chronic pain, fatigue, poor digestion, or a general sense of imbalance.

The Osteopathic Approach in Structural - Function Relationship

Osteopathic physicians (DOs) are trained to recognize and treat these subtle structural issues using a hands-on technique called Osteopathic Manipulative Treatment (OMT). This therapeutic approach involves assessing the body for restrictions and gently restoring balance in joints, muscles, fascia, and other tissues. When we restore the structural integrity, function tends to improve as well. OMT may enhance:

- Circulation and lymphatic flow

- Nervous system regulation

- Respiratory and digestive efficiency

- Postural awareness and movement coordination

This approach is gentle, individualized, and supports the body’s natural ability to heal.

GERD and Structural Imbalance

One common condition that highlights the structure-function relationship is gastroesophageal reflux disease (GERD).

How Structure Influences GERD

Poor posture—particularly slouching or forward head positioning—can compress abdominal contents and limit diaphragmatic mobility. These restrictions can affect the tone and function of the lower esophageal sphincter (LES), the muscular valve that prevents stomach acid from rising into the esophagus. When the LES is compromised, acid reflux symptoms can increase. Contributing postural habits: Prolonged sitting, collapsed torso, restricted breathing mechanics.

GERD: A Growing Concern

The prevalence of GERD has steadily increased over the past three decades, especially in North America and East Asia. A 2017 meta-analysis published in Gut reported that GERD symptoms in the U.S. rose from 12% in the 1990s to over 20% in the 2010s.This rise parallels modern lifestyle changes, including:

- Increased sedentary behavior and screen time

- Higher obesity rates

- Greater intake of processed foods and large meal portions

- Elevated stress levels and disrupted sleep patterns

- Frequent use of NSAIDs and other medications

- Poor postural habits that impair LES function

From an osteopathic perspective, addressing thoracic and diaphragmatic restrictions through OMT can help restore function and reduce symptoms of reflux. By improving structural balance, patients may experience better digestion, less discomfort, and improved quality of life.