Abstract
Osteopathic manipulative treatment (OMT) is used to treat chronic pain conditions. However, few guidelines focusing on chronic pain management include recommendations for OMT. To evaluate previous literature on the use of OMT for improving chronic pain. A literature search was conducted on MEDLINE/PubMed and ScienceDirect on August 26-27, 2019, using theterms "osteopathic," "chronic," and "pain," yielding a total of 312 MEDLINE/PubMed articles and 515 ScienceDirect articles. Eligibility criteria required that studies investigate pain, functional status, or medication usage through an experimental design, focusing on human subjects with chronic pain who had various forms of OMTadministered by osteopathically trained individuals in which the comparator group received no intervention, asham or placebo, or conventional care. Three authors independently performed literature searches and methodically settled disagreements over article selection. In the 22 articles included in our study that examined OMT use in chronic pain conditions, we evaluated primary outcomes of pain (22; 100%) and functional status (20; 90.9%), and the secondary outcome of medication usage (3; 13.6%). The majority of articles showed that OMTresulted in a significant decrease in pain levels as compared to baseline pain levels or the control group (20;90.9%) and that OMT resulted in an improvement in functional status (17; 77.3%). In articles that did not find a significant difference in pain (2; 9.1%) or functional status (3;13.6%), there were overall outcomes improvements noted. All articles that investigated medication usage (3;13.6%) showed that OMT was effective in decreasing patients' medication usage. Our study was limited by its small sample size and multimodal comparator group exclusion. OMT provides an evidence-based management option to reduce pain levels, improve functional status, and decrease medication usage in chronic pain conditions, especially low back pain (LBP). Pain management guidelines should include OMT as a resource to alleviate chronic pain.
Highlights
Context: Osteopathic manipulative treatment (OMT) is used to treat chronic pain conditions
Eligibility criteria required that studies investigate pain, functional status, or medication usage through an experimental design, focusing on human subjects with chronic pain who had various forms of OMT administered by osteopathically trained individuals in which the comparator group received no intervention, a sham or placebo, or conventional care
In the 22 articles included in our study that examined OMT use in chronic pain conditions, we evaluated primary outcomes of pain (22; 100%) and functional status (20; 90.9%), and the secondary outcome of medication usage (3; 13.6%)
Summary
Context: Osteopathic manipulative treatment (OMT) is used to treat chronic pain conditions. Results: In the 22 articles included in our study that examined OMT use in chronic pain conditions, we evaluated primary outcomes of pain (22; 100%) and functional status (20; 90.9%), and the secondary outcome of medication usage (3; 13.6%). Conclusions: OMT provides an evidence-based management option to reduce pain levels, improve functional status, and decrease medication usage in chronic pain conditions, especially low back pain (LBP). The purpose of this study was to conduct a systematic literature review focusing on the efficacy of using various forms of OMT to treat chronic pain conditions through its effects on pain, functional status, and medication usage, demonstrating that the benefits of OMT provide evidence for incorporation into future guidelines focusing on chronic pain management
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