Article on CNN about osteopathy

[annushka]

On a regular basis, I get emails from friends who know I go to an osteopathic school--with various articles about osteopathy. This one is a little old, but it sounds really interesting:
http://www.cnn.com/HEALTH/9911/03/back.pain.care.wmd/index.html

To quote it, "People with chronic low back pain who were treated with osteopathic manipulation used less medication and recovered as well as those who received standard medical care, a new study suggests."

I'm just wondering if there have been more studies like this, and how conclusive were they?

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[moo]

I think there have been many studies that have shown that OMM is equal (but not greater) in efficacy in reducing low back pain. The patient can choose OMM over medications if he/she wants, but the real question is, is it worth the cost?

"Let's diverge at the treatment point," explained Shekelle, an internist at the Greater Los Angeles VA Healthcare System. "I give you a month's worth of drugs and tell you to come back; versus treatment point B, where you would get six or eight visits, or whatever, to the osteopath. In the real world, you'd get two doctor visits.

"Now the question is whether you think those six osteopath visits are going to be less than the cost of a month's ibuprofen. No way. No way, man!"

 

[sophiejane]

I think there have been many studies that have shown that OMM is equal (but not greater) in efficacy in reducing low back pain. The patient can choose OMM over medications if he/she wants, but the real question is, is it worth the cost?

"Let's diverge at the treatment point," explained Shekelle, an internist at the Greater Los Angeles VA Healthcare System. "I give you a month's worth of drugs and tell you to come back; versus treatment point B, where you would get six or eight visits, or whatever, to the osteopath. In the real world, you'd get two doctor visits.

"Now the question is whether you think those six osteopath visits are going to be less than the cost of a month's ibuprofen. No way. No way, man!"

It apparently is worth it to the patients of the majority of OMT specialists around the country who are making money hand over fist, pardon the pun.

Any good OMT specialist in any city is going to have a loyal, largely cash-paying following of patients who swear by the treatments they get. Money talks.

 

[Shinken]

Boy, that Dr. Shekelle sounds like a real class act.

I'm surprised he didn't start by saying "Dude!"

 

[skb21]

What I'm interested in learning is if there is a point where OMT is not helpful?

I'm starting my first year, so I don't know a lot about this. Are there cases where after looking at an MRI of a patient's back, you basically don't want to do any manipulation on them?

 

[Idiopathic]

Of course. You cant manipulate away a disk herniation, ankylosing spondylitis or scoliosis, but you can do less direct Rx to improve quality of life. These people might be able to get completely pain-free on meds, but what will that life be worth.

You mainly just want to be careful. Dont manipulate someone with known CA mets (some people say dont do lymphatic work either) and dont do anything that will obviously hurt someone (be careful of that vertebral artery).

That is essentially the absolute contraindication list to OMT that I have learned...you can do some HV/LA on pregnant Px and can do cranial (if you believe in it) on newborns...and everything in between.

 

[sophiejane]

Pts with rheumatoid arthritis are also a no-no for OMT

 

[fuegorama]

Pts with rheumatoid arthritis are also a no-no for OMT

+ Down's Syndrome or any odontoid ligament weakened conditions, open wounds (in area), fever>102 F, osteogenesis imperfecta, pain not improving w/ OMT, neuro deficits, fractures, anticoagulated patients, ANYBODY who isn't begging you to perform ANY manipulation. An unconvincable, uncomfortable pt. is a day in court waiting to happen. Give 'em NSAIDS and a smile!

My school ended our year w/ the contraindications lecture. Doncha think this would have been a good place to start?

 

[gioia]

Hey SophieJane,

How do you know that dedicated OMT patients are largly cash payers? Is there evidence for this?

And aren't you also interested in Geriatrics? Do you think the retiring Baby Boomers will be especially privy to the idea of OMT?

 

[DrMom]

Pts with rheumatoid arthritis are also a no-no for OMT

They're a no-no for cervical HVLA, specifically, not OMT overall.