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Somatic dysfunction
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In osteopathic medicine and osteopathy, somatic dysfunction is defined as the impaired or altered function of related components of the somatic (bodywork) system including: the skeletal, arthrodial, and myofascial structures, and their related vascular, lymphatic, and neural elements. Somatic dysfunction may be evaluated and treated by osteopaths or osteopathic physicians using . Diagnosis Somatic dysfunction is diagnosed via physical examination by an osteopathic physician, which is a physician with the Doctor of Osteopathic Medicine degree (D.O.). The osteopathic physician looks for signs and symptoms related to the somatic dysfunction commonly represented by the mnemonic device "TART" (tissue texture change, asymmetry, restriction, and tenderness) or "STAR" (sensitivity, tissue texture change, asymmetry, restriction). The physician uses techniques such as layer-by-layer palpation and intersegmental range of motion testing to diagnose the somatic dysfunction. Diagnosis usually requires only the use of the physician's hands and fingertips, though instruments such as a goniometer can be used to detect a diminished range of motion. Signs and symptoms Tissue texture changes may include edema, fibrosis, atrophy, rigidity, or hypertonicity of musculature. The evidence for these points remains controversial, though some studies suggest modest sensitivity and specificity for their use in diagnosis. 
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