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Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives

Chronic pain is a common condition that often interferes with work or other activities. Guidelines support the use of non-pharmacological treatments, such as spinal manipulation, in patients with chronic pain. Osteopathic physicians in the United States are uniquely positioned to manage chronic pain...

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Autores principales: Licciardone, John C, Schultz, Matthew J, Amen, Brook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381089/
https://www.ncbi.nlm.nih.gov/pubmed/32765058
http://dx.doi.org/10.2147/JPR.S183170
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author Licciardone, John C
Schultz, Matthew J
Amen, Brook
author_facet Licciardone, John C
Schultz, Matthew J
Amen, Brook
author_sort Licciardone, John C
collection PubMed
description Chronic pain is a common condition that often interferes with work or other activities. Guidelines support the use of non-pharmacological treatments, such as spinal manipulation, in patients with chronic pain. Osteopathic physicians in the United States are uniquely positioned to manage chronic pain because their professional philosophy embraces the biopsychosocial model and they are trained in the use of osteopathic manipulative treatment (OMT) to complement conventional medical care. This narrative review provides current perspectives on the osteopathic approach to chronic pain management, including evidence for the efficacy of OMT based on systematic searches of the biomedical literature and the ClinicalTrials.gov database. Men, persons with low levels of education, and non-White and Hispanic patients are significantly less likely to have received OMT during their lifetime. Patients with low back and neck pain are most likely to be treated with OMT, and osteopathic manipulative medicine specialty physicians and family medicine physicians most often use OMT. However, many osteopathic physicians report using OMT infrequently. Although OMT is considered safe, based on millions of patient encounters over more than a century, there is limited evidence on its efficacy in treating chronic pain. The lone exception involves chronic low back pain, wherein there is evidence from systematic reviews, a large clinical trial, and observational studies. There is lesser evidence to support cost effectiveness and patient satisfaction associated with OMT for chronic pain. The only clinical practice guideline established by the American Osteopathic Association recommends that OMT should be used to treat chronic low back pain in patients with somatic dysfunction. Given the philosophy of osteopathic medicine, universal training of osteopathic physicians to use OMT, and national guidelines supporting non-pharmacological treatments for chronic pain, it is unclear why OMT use is reported to be remarkably low in physician surveys.
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spelling pubmed-73810892020-08-05 Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives Licciardone, John C Schultz, Matthew J Amen, Brook J Pain Res Review Chronic pain is a common condition that often interferes with work or other activities. Guidelines support the use of non-pharmacological treatments, such as spinal manipulation, in patients with chronic pain. Osteopathic physicians in the United States are uniquely positioned to manage chronic pain because their professional philosophy embraces the biopsychosocial model and they are trained in the use of osteopathic manipulative treatment (OMT) to complement conventional medical care. This narrative review provides current perspectives on the osteopathic approach to chronic pain management, including evidence for the efficacy of OMT based on systematic searches of the biomedical literature and the ClinicalTrials.gov database. Men, persons with low levels of education, and non-White and Hispanic patients are significantly less likely to have received OMT during their lifetime. Patients with low back and neck pain are most likely to be treated with OMT, and osteopathic manipulative medicine specialty physicians and family medicine physicians most often use OMT. However, many osteopathic physicians report using OMT infrequently. Although OMT is considered safe, based on millions of patient encounters over more than a century, there is limited evidence on its efficacy in treating chronic pain. The lone exception involves chronic low back pain, wherein there is evidence from systematic reviews, a large clinical trial, and observational studies. There is lesser evidence to support cost effectiveness and patient satisfaction associated with OMT for chronic pain. The only clinical practice guideline established by the American Osteopathic Association recommends that OMT should be used to treat chronic low back pain in patients with somatic dysfunction. Given the philosophy of osteopathic medicine, universal training of osteopathic physicians to use OMT, and national guidelines supporting non-pharmacological treatments for chronic pain, it is unclear why OMT use is reported to be remarkably low in physician surveys. Dove 2020-07-20 /pmc/articles/PMC7381089/ /pubmed/32765058 http://dx.doi.org/10.2147/JPR.S183170 Text en © 2020 Licciardone et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Licciardone, John C
Schultz, Matthew J
Amen, Brook
Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives
title Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives
title_full Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives
title_fullStr Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives
title_full_unstemmed Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives
title_short Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives
title_sort osteopathic manipulation in the management of chronic pain: current perspectives
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381089/
https://www.ncbi.nlm.nih.gov/pubmed/32765058
http://dx.doi.org/10.2147/JPR.S183170
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