Frequently Asked Questions

Does Peine Osteopathic Medicine accept insurance?
Peine Osteopathic Medicine accepts most insurance, excluding Regence Blue Shield of Idaho, Medicaid, and Medicare. Please contact the office to verify coverage and benefits prior to scheduling an appointment: (208) 947-0925.

What is Osteopathic Medicine?
Osteopathic medicine is a healing discipline with the goal of creating optimum health through a unique approach to the whole patient. Physicians trained in osteopathic medicine receive the degree of “D.O.”, or Doctor of Osteopathic Medicine. D.O.s are fully licensed physicians like their M.D. counterparts, but have also received hundreds of hours of additional training learning to treat medical conditions with their hands using osteopathic manipulation. Like M.D.s, osteopathic physicians can be pediatricians, surgeons, or family doctors, but some choose to limit their practice to osteopathic manipulation. Some D.O.s also choose to receive extra training in advanced techniques such as cranial osteopathy, an especially gentle technique that can even be used on newborn babies.

For over 125 years, osteopathic physicians have been trained to recognize the body as a whole. The osteopathic philosophy recognizes the person as a tightly regulated and integrated being, rather than a collection of independently operating systems. The contribution of mind and spirit to the health of the body is also an important concept that has been a part of osteopathic medicine for over a century. Additionally, osteopathic philosophy emphasizes the innate ability of the body to heal itself as a primary method for addressing medical conditions. Combined with modern medical and surgical training, these unique ideas allow D.O.s to provide unparalleled holistic health care for their patients.

What happens during a treatment?
Successful treatment begins with comprehensive assessment of the patient, including the contribution of mental and emotional factors to the disease process. Evaluation of proper biomechanics is also considered, especially in cases of sports injuries or repetitive strain injury. Though most osteopathic physicians are trained to use thrusting maneuvers that resemble chiropractic, there are many other gentler techniques that are also equally effective.  The treatment experience will be different for each patient depending on the osteopathic technique chosen.

Some D.O.s have sought additional training in advanced manipulative techniques to more successfully address difficult cases. Cranial osteopathy is one such technique. Known for its gentleness as well as its effectiveness, it can be used to treat any part of the body to relieve residual tissue restriction resulting from old traumatic injuries. Gentle traction and pressure are used to precisely balance tension in all body regions, thereby restoring the tissues to their proper relationships and maximizing their potential for optimal function. Because of its subtlety, cranial osteopathy is particularly suited for young children, even newborns. Due to the physical forces involved in the birth process, many children experience tissue restrictions that can lead to such problems as nursing difficulties and recurrent ear infections. Many times these “birth injuries” can be successfully addressed in one or two treatments.

Dr. Peine specializes in using these advanced, very gentle techniques to treat his patients. He frequently recommends exercises for stretching, strengthening, and balancing when necessary. He also may recommend other types of healing modalities (acupuncture, pilates, etc.) and mind-body techniques to speed the healing process and augment the effects of any other medical or surgical treatment a patient may be undergoing.

How does osteopathic manipulation work?
Osteopathic physicians are trained to recognize that all body systems work together in an innate expression of unity and interaction. With an understanding of the complex interrelationship between structure and function, D.O.s can use manipulation to restore the body’s tissues to their proper anatomical relationships, which then allows the body to function optimally. Nerves, blood vessels, muscles, and other important structures are all affected by areas of tissue restriction, or “tightness.” By using manipulation to carefully relieve the restricted areas, D.O.s assist the body’s natural healing ability by improving blood flow, nerve function, and lymphatic drainage. D.O.s may also prescribe medication or recommend other treatments to speed the healing process.

What kinds of conditions may be treated?
A number of bone, muscle, and joint conditions may be successfully treated with osteopathic manipulation:

  • Upper and lower back pain due to disc problems, muscle strain, overuse, traumatic injury, arthritis, etc.
  • Neck pain due to whiplash, muscle tension/stress, traumatic injury, etc.
  • Shoulder pain due to rotator cuff problems, bursitis, arthritis, pinched nerves, frozen shoulder, etc.
  • Hip pain and sciatica
  • Arm and hand pain due to tennis elbow, carpal tunnel syndrome, etc.
  • Leg, knee, and foot pain due to sciatica, sports injuries, pinched nerves, ankle injuries, etc.

Additionally, a number of other chronic and tough-to-treat conditions may respond to osteopathic manipulation, especially if other treatments such as drugs and surgery have not been helpful:

  • Chronic sinusitis and nasal congestion
  • Headaches, tension, or migraine
  • Women’s and pregnancy issues
  • Vertigo and dizziness
  • Acid reflux

Advanced manipulation techniques such as cranial osteopathy allow appropriately trained physicians to effectively address chronic problems related to old traumatic injuries. An added benefit is the ongoing improved sense of well-being and health often experienced with routine osteopathic care.

Can children be treated with osteopathic manipulation?
Children may receive the greatest benefit from osteopathic care because of the adverse effects of tissue restriction on their rapid growth and development. Techniques involving gentle traction and pressure such as cranial osteopathy, myofascial release, and balanced ligamentous tension can even be used on newborn babies!

Children are subject to numerous falls and minor injuries, which can result in tissue restriction. Additionally, unlike many conventional health care providers, osteopathic physicians are trained to recognize problems in newborns that may result from a “traumatic” birth process. As most mothers know, contractions during labor generate a tremendous amount of force. In certain situations, these forces may cause subtle restrictions in the newborn’s tissues that can contribute to many common childhood illnesses:

  • Newborn nursing problems and poor weight gain
  • Recurrent ear infections
  • Asthma and respiratory problems
  • Colic and reflux
  • Torticollis
  • Orthopaedic concerns

What types of problems do not benefit from osteopathic manipulation?
Osteopathic manipulation has limitations like any other healing discipline. Just as pharmaceutical drugs and surgery cannot cure all illness, osteopathic manipulation cannot be used to successfully treat every problem. However, if it is used appropriately, it can be quite helpful, especially in cases where other more conventional treatments have failed.

How does osteopathic manipulation differ from chiropractic?
This is a very common question that is difficult to answer in a concise manner for a number of reasons.

First and foremost, both osteopathic medicine and chiropractic are very diverse disciplines. Both encompass a wide range of techniques ranging from conventional thrusting or “popping and cracking” maneuvers to very subtle, gentle advanced techniques. Because of this diversity, a superficial comparison that doesn’t take into account all of the different techniques in both osteopathy and chiropractic will be misleading.

Second, both osteopathic medicine and chiropractic are “operator dependent.” This means that, like surgery, they both depend on the person carrying out the procedure. This makes a precise comparison between the two even more difficult because some osteopathic physicians are more skilled than some chiropractors, and vice versa. In a sense, the ability of the practitioner is much more important than the training he or she has received.

Historically, chiropractic has maintained its distinction and separateness from conventional medicine. Osteopathic medicine, by contrast, has evolved to incorporate conventional medicine into its practice. Accordingly, chiropractic physicians are not educated in modern medical and surgical techniques to the extent that osteopathic physicians are, and are not considered fully licensed physicians like their M.D. and D.O. counterparts.

These philosophical and historical differences aside, there are some notable differences in the focus of chiropractic and osteopathic manipulation. Chiropractic physicians tend to focus on the bones of spine with thrusting or “popping and cracking” maneuvers intended to improve the function of the nervous system. In contrast, osteopathic manipulation can be used on any area of the body, frequently involving treatment of muscle, soft tissue, etc. Osteopathic medicine also encompasses a more diverse group techniques than chiropractic.

Because of their familiarity with modern medicine, osteopathic physicians sometimes incorporate pharmaceuticals and other therapeutic modalities into their treatment plans. They also tend to see their patients once a week or less, whereas chiropractors tend to see their patients more than once a week during the treatment of an acute problem.

Functional Medicine

Functional medicine seeks to identify and address the root causes of disease and prevent illness rather than treating symptoms. It views the body as an interconnected, dynamic system, rather than a collection of independent organ systems. It is a wholistic approach that believes the body is composed of mind, body, and spirit and that the body has the ability to heal when all aspects of health are optimized. Functional medicine is patient-centered and engages the patient in the healing process, in a therapeutic partnership, much like an athlete-coach relationship. The patient is the “smartest doctor” and spending the time to listen to their histories is crucial to discovering the true causes of complex, chronic diseases. Functional medicine utilizes a systems-oriented approach to address all aspects of health, including nutrition, lifestyle, genetics, and unique biochemistry. Each patient is unique and requires a personalized treatment plan to address their specific requirements for true healing using a combination of therapies including nutrition, lifestyle changes, and supplements.

Low Dose Immunotherapy

What is LDI?
Low Dose Immunotherapy (LDI) is a treatment for increasing immune “tolerance” of an overactive immune system. Allergy and autoimmunity represent an alteration or overactivation of appropriate immune tolerance. LDI retrains the immune system for specific antigens, thereby decreasing overactive immune response and decreasing symptoms.

This type of immunotherapy was discovered in Great Britain in the 1970s and called “Enzyme Potentiated Desensitization” (EPD). The technique utilized very small concentrations of antigens along with an enzyme, beta glucuronidase, which helps educate the T cells involved in the immune response. This treatment was brought to the US, but in the early 1990s the FDA stopped the importation of EPD. At this point, Dr. Shrader reproduced the mixtures of EPD and called them LDA. LDA originally used antigens causing certain allergies and the technique was later expanded by Dr. Vincent to treat various autoimmune conditions using a variety of different antigens, called LDI.

LDI for Autoimmune Diseases
Autoimmune diseases and conditions that involve an overactive immune system (like allergies) can be treated with LDI. It is now understood that many autoimmune diseases are “triggered” by an initial infection. Sometimes, when the immune system recognizes the infection and mounts an attack, through an antibody-mediated immune response, there is a cross reactivity with the body’s own tissue. This process is called “molecular mimicry.” A good example of this is Rheumatic Fever, where damage to the heart can occur after the Streptococcus infection is treated. Often there can be more than one trigger for a disease process.

The key is recognizing the difference between an “infection” and an “immune reaction.” Infections involve an organism in a place where it doesn’t belong and antimicrobial therapy is curative, i.e. pneumonia, cellulitis, endocarditis, etc. An “immune reaction” is an inflammatory response to an organism that is either a normal organism in the human body, or is not improved with antimicrobial therapy. Chronic Lyme disease is another example of an “immune-mediated” process rather than an “infection.” Many people without Lyme Disease symptoms harbor the bacteria that causes Lyme Disease. Symptoms often do not resolve with antibiotic treatment in Chronic Lyme Disease. Symptoms often return after treatment with antibiotics.

What conditions respond well to LDI?

  • Food allergies/sensitivities, environmental allergens, chemical sensitivities, mold sensitivity
  • Eczema, acne, rashes
  • Chronic Fatigue
  • Crohn’s disease, Ulcerative Colitis, IBS
  • Yeast sensitivity
  • Endometriosis
  • Chronic Lyme Disease
  • Rheumatoid Arthritis, Ankylosing Spondylitis, generalized joint pain
  • Fibromyalgia
  • Herpes outbreaks
  • Chronic Sinusitis

What is the procedure for LDI?
Patients will first undergo a history and physical to determine if LDI or LDA are appropriate therapeutic techniques. Often lab work will be done prior to LDI or LDA therapy to help guide therapy. LDA and LDI doses are given by administering a small drop (less than 1 ml) of the enzyme and antigen mixture under the tongue. Doses are typically repeated every 7–8 weeks, but “booster” doses can be given as soon as 1–2 weeks, based on response to the first dose. The key to LDI is finding the right concentration that the immune system responds to. Concentrations range from 4c up to 20c, or more, if needed. “1c” refers to a 100:1 dilution, and each successive number is another 100:1 dilution.

Because there can be multiple different antigens that trigger the patients’ symptoms, multiple antigens may need to be given before symptoms fully improve. Once we find the antigen or antigens that alleviate symptoms, the antigens can be combined and given together.

What can I expect after LDI treatment?
There are three things that can happen after a dose.

  1. If the dose is too weak, there will be no change in symptoms. We can then proceed with the next stronger concentration in 1–2 weeks.
  2. If the dose is too strong, there will be a flare in symptoms. Flares usually occur in the first 72 hours and usually last a day or two, but can last up to several weeks. A flare is not necessarily a bad thing, because we know we have chosen the right antigen. If we get a flare, we must wait 7–8 weeks for the immune system to “reset.”
  3. If the dose is almost strong enough, there will be a temporary improvement in symptoms, but not lasting the full goal of 7 weeks or more. If this is the case, we know we are close to the right strength, but need to give a slightly stronger dose. We can then give a “booster” dose in 2 weeks.

Once the correct dose is found, doses are given every 7–8 weeks, sometimes with “booster” doses, as needed. Often, patients see longer and longer improvements in symptoms and can space doses out longer than 7–8 weeks, and sometimes are able to stop completely.

For more information, click here to download the LDI Patient Handout pdf.