Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Mar 1;121(3):307-317.
doi: 10.1515/jom-2019-0284.

Support for osteopathic manipulative treatment inclusion in chronic pain management guidelines: a narrative review

Megan Franzetti  1 , Emily Dries  1 , Brady Stevens  1 , Lisa Berkowitz  1 , Sheldon C Yao  2
Affiliations
Free article
Review

Support for osteopathic manipulative treatment inclusion in chronic pain management guidelines: a narrative review

Megan Franzetti et al. J Osteopath Med. .
Free article

Abstract

Context: Osteopathic manipulative treatment (OMT) is used to treat chronic pain conditions. However, few guidelines focusing on chronic pain management include recommendations for OMT.

Objectives: To evaluate previous literature on the use of OMT for improving chronic pain.

Methods: A literature search was conducted on MEDLINE/PubMed and ScienceDirect on August 26-27, 2019, using the terms "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 OMT administered by osteopathically trained individuals in which the comparator group received no intervention, a sham or placebo, or conventional care. Three authors independently performed literature searches and methodically settled disagreements over article selection.

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%). The majority of articles showed that OMT resulted 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.

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). Pain management guidelines should include OMT as a resource to alleviate chronic pain.

PubMed Disclaimer

References

    1. National Center for Complementary and Integrative Health Staff. Chronic pain: in depth. National Center for Complementary and Integrative Health Web site. https://nccih.nih.gov/health/pain/chronic.htm [Accessed 23 Oct 2019].
    1. Zelaya, CE, Dahlhamer, JM, Lucas, JW, Connor, EM. Chronic pain and high-impact chronic pain among U.S. adults, 2019. NCHS Data Brief, no 390. Hyattsville, MD: National Center for Health Statistics; 2020.
    1. National Institute for Neurological Disorders and Stroke Staff. Low back pain fact sheet. National Institute for Neurological Disorders and Stroke Web site. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-She... [Accessed 23 Oct 2019].
    1. NIH fact sheets – pain management. National Institutes of Health. https://archives.nih.gov/asites/report/09-09-2019/report.nih.gov/nihfact.... [Accessed 23 Oct 2020].
    1. Dowell, D, Haegerich, TM, Chou, R. CDC guideline for prescribing opioids for chronic pain – United States, 2016. MMWR Recomm Rep (Morb Mortal Wkly Rep) 2016;65:1–49. https://doi.org/10.15585/mmwr.rr6501e1.

LinkOut - more resources