The Role of Osteopathic Manipulative Treatment in Osteoarthritis: A Scoping Review

Abstract

Osteoarthritis (OA) is one of the most common joint disorders in the United States. As no whole body, curative treatment exists, conservative, often multimodal, treatment goals are used first with aims to decrease pain and improve function in daily life. This scoping review seeks to understand how incorporating osteopathic manipulative treatment (OMT) in the management of OA can affect patient outcomes, specifically pain and mobility. This was explored by searching CINAHL, EBSCO, Web of Science, EMBASE, and Ovid MEDLINE(R) databases on 11/18/2022. Search terms included: [("osteoarthr*") OR ("degenerative arthr*") OR ("degenerative joint disease") OR ("noninflammatory arthr*") OR ("osteo arthr*")] AND [("osteopath*") OR (omt) OR (omm) OR ("manipulat* medicine")]. Inclusion criteria were articles that identified the use of OMT or manipulation in the OA treatment of adults. A total of 488 articles were extracted. After duplicates were removed, 353 articles remained. Seven articles were included; five primary articles and two review articles. Across five eligible primary articles, 186 patients were identified. Articles were assessed for the use and effectiveness of an OMT treatment plan for pain reduction and improved outcomes, including but not limited to, range of motion (ROM), functionality, and quality of life. OMT is a safe and effective method able to be used alone or in combination with other treatments for OA. There is reasonable preliminary evidence to suggest OMT can be used to provide statistically significant improvement in pain, joint stiffness, ROM, functionality scores, and physical exam findings, but future large-scale clinical trials are recommended.

Keywords: alternative medical therapies; complimentary medicine; geriatric; nonsteroidal anti-inflammatory drugs (nsaids); osteoarthritis (oa); osteopathic manipulative medicine (omm); osteopathic manipulative treatment (omt); osteopathic principles and practice (opp); physical medicine and rehabilitation; total joint arthroplasty.

Figure 1. Flow chart of PRISMA selection process used (and numbered) to identify total articles, screening for eligibility and those included

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; n: Number