Is the philosophy of osteopathic medicine not using medicine at all?

[Siggy]

The difference is that you don't charge patients extra for using the backboard. But you can sure as hell charge a patient extra for moving their fascia around to 'promote the body's innate ability to fight infection and restore mind, body, and spirit.'

Also, what do you mean backboards in trauma pts? What would you like them to use in the field?

For spinal immobilization? A firm mattress. If you need to use one to move a patient, then sure (albeit a scoop is better than a backboard), but for general transport, a backboard isn't needed, none of it is supported by any evidence that it reduces incident of spinal injury.

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[ortnakas]

The fact that you had to say "i think" in this post is proof that OMM isnt useful.

Also, I think Panera's are delicious, the New England Patriots are evil, and that flashcards are a useful study tool. Sometimes "I think" means it's someone's opinion-- not a reflection of the topic being discussed (which obviously is debatable, because here we are debating it.)

We all feel sorry for you guys. I honestly think your opinion of OPP would be completely different if a certain someone wasn't running the course. It's bad enough for us, but you guys have to deal with it practically from day one.

Anyway, the idea behind CS is about general tightness in the area. Your goal is basically to loosen all the tissue in the region (e.g. CS on a specific muscle involves approximating the origin and insertion). Working on that premise, I think it can be effective, no idea when though, but CS has worked pretty well on my parents (not so much on me and my wife). I don't think the 70% reduction stuff are hard rules, but just a method they used to define something they are not sure about. Remember it for the exams and practicals to get the answer right, but that's about it.

Completely agree with your assessment at the end.

Thanks for the sentiments, and the CS explanation. We're dying right now.

 

[shibby1111]

Which schools focus most on OMM out of all the DOs?

No DO school focuses on OMM. Medical school, DO or MD, focuses on medicine. You will spend <2 hours/week studying OMM and >50-80 hours/week studying actual medical stuff.

Medicine consists of meeting with a patient, recognizing signs and symptoms, deciding which tests will narrow/support your diagnosis, and choosing from a list of pills or procedures to treat that patient. OMM will get in your way of studying those processes. You'll test yourself on how little you can study OMM and still pass. Eventually you'll fail an OMM test, and then you'll be right back on this forum with precisely the same complaints that you're currently criticizing others for having.

 

[WingedOx]

...and then you get into medical school and residency and realize there's a lot of quackery and evidence resistant treatment ideas in all of medicine. For example, how many people still subscribe to backboards in trauma patients (thankfully, this has recently started to change) and trendelenburg in hypotensive patients? Oh, but yea, OMM is the only quackery in medicine, despite there being evidence for some of it.

...which is why you see so many MDs (and DOs) chiming in on this topic. If you are willing to accept anecdotal evidence for the valildity of one of the core componenets of your profession, where else are you going to be willing to abandon evidence-based medicine? Antivaxxer nonsense? KT Tape? Homeopathy? invasive surgical procedures that aren't shown to have improved outcomes compared to rest and PT alone? Using the flashy new expensive drug that the sexy blonde rep peddles at your office when the tried and true 20 year old generic does the same thing with a similar side effect profile? Every single one of these gets peddled by MDs/DOs.

Medical students/residents/attendings are all notoriously bad at evaluating evidence/literature. Being good at it requires a healthy dose of skepticism, and unfortunately, OMM advocates encourage leaving skepticism and data analysis at the door very early in the process of medical education (as evidenced by some of the postings early in this thread). It's extremely disheartening as a physicians to see other professionals cite "I've seen it work" as evidence of a treatment's effectiveness, and such lack of critical evaluation is something that needs to be attacked early on in medical training.

 

[moonwake]

No DO school focuses on OMM. Medical school, DO or MD, focuses on medicine. You will spend <2 hours/week studying OMM and >50-80 hours/week studying actual medical stuff.

Medicine consists of meeting with a patient, recognizing signs and symptoms, deciding which tests will narrow/support your diagnosis, and choosing from a list of pills or procedures to treat that patient. OMM will get in your way of studying those processes. You'll test yourself on how little you can study OMM and still pass. Eventually you'll fail an OMM test, and then you'll be right back on this forum with precisely the same complaints that you're currently criticizing others for having.

For the record I'm not criticizing anyone - I just thought it was funny how a MD student would be trashing on OMM since he didn't have it in his curriculum. I'm not saying anything about OMM- and from the general consensus it sounds like I probably won't enjoy it haha.

 

[GUH]

...which is why you see so many MDs (and DOs) chiming in on this topic. If you are willing to accept anecdotal evidence for the valildity of one of the core componenets of your profession, where else are you going to be willing to abandon evidence-based medicine? Antivaxxer nonsense? KT Tape? Homeopathy? invasive surgical procedures that aren't shown to have improved outcomes compared to rest and PT alone? Using the flashy new expensive drug that the sexy blonde rep peddles at your office when the tried and true 20 year old generic does the same thing with a similar side effect profile? Every single one of these gets peddled by MDs/DOs.

Medical students/residents/attendings are all notoriously bad at evaluating evidence/literature. Being good at it requires a healthy dose of skepticism, and unfortunately, OMM advocates encourage leaving skepticism and data analysis at the door very early in the process of medical education (as evidenced by some of the postings early in this thread). It's extremely disheartening as a physicians to see other professionals cite "I've seen it work" as evidence of a treatment's effectiveness, and such lack of critical evaluation is something that needs to be attacked early on in medical training.

OMM is definitely not the only area in which I've seen attendings deliberately treat patients based on their personal experience, patient preferences, and clinical judgment. Do all of your faculty stick with a flow chart in 100% of their patients?
And while the literature for some aspects of OMM is not as established as other treatments, there is at least still good evidence for some of it, as described earlier in this thread. There is also minimal risk to patients if applied correctly. To compare OMM in its entirety to the anti-vaccination movement, which actually causes significant harm to large numbers of people every year, is nonsense. You would have more success (and serve the profession better) by focusing on those parts which are more controversial.

 

[GUH]

For the record I'm not criticizing anyone - I just thought it was funny how a MD student would be trashing on OMM since he didn't have it in his curriculum. I'm not saying anything about OMM- and from the general consensus it sounds like I probably won't enjoy it haha.

DO students on SDN tend to be much more opposed to actually learning osteopathic medicine (including OMM) than most students you'll meet at school, many of whom actually want to be DOs.

 

[moonwake]

DO students on SDN tend to be much more opposed to actually learning osteopathic medicine (including OMM) than most students you'll meet at school, many of whom actually want to be DOs.

Well one thing is for sure - extremely outspoken people who are super opinionated and attack at anything lurk on here. I'm pretty sure people come on here just to relieve stress by belittling people on SDN- OMM or any other reason. For some people there's roadrage, for others there's SDN.

 

[RadsonRads]

For the record I'm not criticizing anyone - I just thought it was funny how a MD student would be trashing on OMM since he didn't have it in his curriculum. I'm not saying anything about OMM- and from the general consensus it sounds like I probably won't enjoy it haha.

Prob same reason they can trash homeopathy or chiros. There is no evidence that supports it, therefore you can assume it's crap

 

[kderekb]

"You'll test yourself on how little you can study OMM and still pass."

Haha too true!

 

[GUH]

Prob same reason they can trash homeopathy or chiros. There is no evidence that supports it, therefore you can assume it's crap

Incorrect. Again, "no" evidence has a specific meaning.

 

[shibby1111]

Incorrect. Again, "no" evidence has a specific meaning.

A case report about it working on 2 dogs, or a study where they found it worked on a human cadaver isn't evidence.

 

[GUH]

A case report about it working on 2 dogs, or a study where they found it worked on a human cadaver isn't evidence.

Too bad that isn't what was being discussed.

 

[RadsonRads]

Incorrect. Again, "no" evidence has a specific meaning.

Man you really are holding onto the study 16yrs ago that states no significant difference like it has had the biggest impact in medicine in our time.

Dude cites 1 study with no benefit and thinks OMM is everything

 

[GUH]

Man you really are holding onto the study 16yrs ago that states no significant difference like it has had the biggest impact in medicine in our time.

Dude cites 1 study with no benefit and thinks OMM is everything

Nobody's saying that OMM is everything. It's not reasonable to write off a study in a good journal just because it's older.

 

[Siggy]

...which is why you see so many MDs (and DOs) chiming in on this topic. If you are willing to accept anecdotal evidence for the valildity of one of the core componenets of your profession, where else are you going to be willing to abandon evidence-based medicine? Antivaxxer nonsense? KT Tape? Homeopathy? invasive surgical procedures that aren't shown to have improved outcomes compared to rest and PT alone? Using the flashy new expensive drug that the sexy blonde rep peddles at your office when the tried and true 20 year old generic does the same thing with a similar side effect profile? Every single one of these gets peddled by MDs/DOs.

Medical students/residents/attendings are all notoriously bad at evaluating evidence/literature. Being good at it requires a healthy dose of skepticism, and unfortunately, OMM advocates encourage leaving skepticism and data analysis at the door very early in the process of medical education (as evidenced by some of the postings early in this thread). It's extremely disheartening as a physicians to see other professionals cite "I've seen it work" as evidence of a treatment's effectiveness, and such lack of critical evaluation is something that needs to be attacked early on in medical training.

1. There is evidence for some of the treatments (and OMM isn't an all or nothing issue).

2. A lack of evidence is not the same as a lack of efficacy. Look through something like AHA ACLS training and see how much of that is level of evidence C (i.e. "expert opinion").

 

[TankTuck]

...which is why you see so many MDs (and DOs) chiming in on this topic. If you are willing to accept anecdotal evidence for the valildity of one of the core componenets of your profession, where else are you going to be willing to abandon evidence-based medicine? Antivaxxer nonsense? KT Tape? Homeopathy? invasive surgical procedures that aren't shown to have improved outcomes compared to rest and PT alone? Using the flashy new expensive drug that the sexy blonde rep peddles at your office when the tried and true 20 year old generic does the same thing with a similar side effect profile? Every single one of these gets peddled by MDs/DOs.

Medical students/residents/attendings are all notoriously bad at evaluating evidence/literature. Being good at it requires a healthy dose of skepticism, and unfortunately, OMM advocates encourage leaving skepticism and data analysis at the door very early in the process of medical education (as evidenced by some of the postings early in this thread). It's extremely disheartening as a physicians to see other professionals cite "I've seen it work" as evidence of a treatment's effectiveness, and such lack of critical evaluation is something that needs to be attacked early on in medical training.

I did say "I have seen it work," but first I said this is anecdotal... I was sharing my experience, not citing evidence. If you cannot discern between the two maybe you should be a little more critical of yourself before spewing on others. I said I have seen it work, not because I had a brother who was miraculously and magically cured by OMM fairy dust. I said it because 20-30 patients a day receive OMM at our clinic and I have observed and heard (not evidence, my experience) from many hundreds, if not close to a thousand of our patients first hand about the practice's effectiveness, when other medical treatments have left them high and dry. I try to be as skeptical as the next guy, when hearing about an effective treatment. Objective, evidence-based research is important to me. My experience, as long as it is not brief, is just as important to me and I realize it is hard to accept an understand another's experience, but I wanted to share it none the less, considering it is very relevant to this thread. From this experience, I understand that a skilled and knowledgeable osteopath can effectively treat a broad range of patients. I am on this thread to learn more about the practice, weighing if it is something I want to dedicate my life too. A hundred times over, I would rather treat a patient successfully, even if the evidence is lacking, than to be an excessively skeptical physician, sticking with tradition and the main stream. Just my opinion. I'll say it again. Everyone of these OMM threads that could be very informative, end up littered with students bringing up the lack of research. The treatment is personalized, no two physicians practice it exactly the same and this is a big reason why it is so difficult to get repeatable results. I realize this barrier, but I am hopeful that 1) more valid research will be published and 2) that the results will allow for the continuation of the practice. How can you disregard all the patients who have successful results, closing your mind, again and again stating not enough research. Please be constructive with your comments. Also, if you are disheartened by a harmless comment of someone's experience in an osteopathy thread about OMM, you should really consider that self-reflection.

 

[RadsonRads]

Nobody's saying that OMM is everything. It's not reasonable to write off a study in a good journal just because it's older.

Nobody is writing off the study. The study states that OMM is the same as standard of care for tx of LBP. This is the only published study in history and it states there is no difference. Yet you still keep referencing it like it is the word of god

 

[Siggy]

A case report about it working on 2 dogs, or a study where they found it worked on a human cadaver isn't evidence.

...but I do love the mental image of doing pedal pumps on dogs.

 

[GUH]

Nobody is writing off the study. The study states that OMM is the same as standard of care for tx of LBP. This is the only published study in history and it states there is no difference. Yet you still keep referencing it like it is the word of god

Read it again.
And yes, evidence is important.

 

[Siggy]

Man you really are holding onto the study 16yrs ago that states no significant difference like it has had the biggest impact in medicine in our time.

Dude cites 1 study with no benefit and thinks OMM is everything

No benefit and equivalent benefit are two different things. It didn't say no benefit, it said it was the same.

 

[RadsonRads]

No benefit and equivalent benefit are two different things. It didn't say no benefit, it said it was the same.

You are correct. I let my bias get the best of me..

 

[moonwake]

For what it's worth I work at a health-food store and you won't believe the amount of placebo-effect junk there is out there. Or skewing facts or info to convince uneducated people. My best bet is OMM may work for some people and it may just be the same genre of placebo-effect as chiro is for certain people. It's hard to go to either extreme or get scientific hard evidence that medicine is based on. I get why people don't believe it works.

 

[GUH]

For what it's worth I work at a health-food store and you won't believe the amount of placebo-effect junk there is out there. Or skewing facts or info to convince uneducated people. My best bet is OMM may work for some people and it may just be the same genre of placebo-effect as chiro is for certain people. It's hard to go to either extreme or get scientific hard evidence that medicine is based on. I get why people don't believe it works.

Spinal manipulation is endorsed by the ACP for chronic low back pain as at least equal to any other documented intervention to treat this condition. If this is solely due to placebo effect then you also have to consider the same regarding use of NSAIDs, exercise therapy, and rehab for chronic LBP as well since the evidence and net benefit are at the same level.

 

[RadsonRads]

Spinal manipulation is endorsed by the ACP for chronic low back pain as at least equal to any other documented intervention to treat this condition. If this is solely due to placebo effect then you also have to consider the same regarding use of NSAIDs, exercise therapy, and rehab for chronic LBP as well since the evidence and net benefit are at the same level.

Ok, so we've proven OMM is similar to standard tx for lbp. What about the other 99.9% of OMM?

 

[shibby1111]

Ok, so we've proven OMM is similar to standard tx for lbp. What about the other 99.9% of OMM?

there is a case study from 1931 about a 31 year old female with bacterial pneumonia who was cured with single OMT treatment consisting of direct muscle energy for rib 1 and hvla for OA sidebent left rotated right. This data show that OMT is superior to antibiotics and other standard medical treatment for bacterial pneumonia.

 

[hallowmann]

"You'll test yourself on how little you can study OMM and still pass."

Haha too true!

Very true. Especially midway through 2nd semester 2nd year, but that might be true for most courses at that point.

Again, I apologize for the bad cards you MS1s were dealt.

A case report about it working on 2 dogs, or a study where they found it worked on a human cadaver isn't evidence.

http://www.ncbi.nlm.nih.gov/pubmed/25175885

That's from a quick search. Not much research on most OMT, but manipulation for LBP has some positive research behind it. Again, not a ton, but more than most other areas of OMT.

...but I do love the mental image of doing pedal pumps on dogs.

Thank you for this.

Ok, so we've proven OMM is similar to standard tx for lbp. What about the other 99.9% of OMM?

I don't think anyone is heralding the efficacy of Cranial and Chapmans, but it certainly doesn't make up the majority of OMT (at least it wasn't at my school with our old course director). Personally, I could do without Cranial completely (no matter how open-minded/willing to consider things I try to be... I. just. can't.), and viscerosomatics should really come with an asterix saying *no clear evidence or something.

Most of my OPP course was based on actual MSK stuff. Cranial consisted of 3 lectures/labs in the fall of MS2 and we had something like 1 lecture/lab each semester on viscerosomatics. More than should be devoted to it, sure, but certainly not majority of the course.

If its the majority at other schools, that's really upsetting. I've honestly had a decent experience with OMT up until this semester (preceptor changed), but I imagine part of that is me being more of a glass-half-full kind of person and looking for the positive/useful things I can get out of the course.

 

[Siggy]

By the way, I'm not joking about lymphatics and dogs either...
http://www.jaoa.osteopathic.org/content/105/10/447.full

 

[hallowmann]

By the way, I'm not joking about lymphatics and dogs either...
http://www.jaoa.osteopathic.org/content/105/10/447.full

Oh I know, I remember hearing about it, you just reintroduced the mental picture into my mind.

 

[Siggy]

Yea, but what about everyone else?

 

[wjs010]

So far, OMM has been more stressful than regular medicine

 

[TankTuck]

You just opened up the s*** gates. Now we wait for all the "there is no evidence posts."

 

[wjs010]

You just opened up the s*** gates. Now we wait for all the "there is no valid evidence" posts.

I just mean , although studying for the written indeed only takes 2-3 days before tests, the practicals are so stressful that taking regular medicine tests come nowhere close to OMM practicals. Most of the people in my class feel a little ill in the stomach at the thought of a practical. It is harder than tests too, because sometimes not failing involves luck.

 

[Petypet]

The day I had preceptor moving a guys ankle and asking me to see if I can see the difference in the CRI at the patient's skull, I lost all faith in OMT. I just made up some bogus crap of yeah and I feel a lateral strain, and he agreed with me. These are the same bonus docs that approve studies in JAOA.

I just mean , although studying for the written indeed only takes 2-3 days before tests, the practicals are so stressful that taking regular medicine tests come nowhere close to OMM practicals. Most of the people in my class feel a little ill in the stomach at the thought of a practical. It is harder than tests too, because sometimes not failing involves luck.

The key is confidence. Fake it till you make it.

 

[wjs010]

The day I had preceptor moving a guys ankle and asking me to see if I can see the difference in the CRI at the patient's skull, I lost all faith in OMT. I just made up some bogus crap of yeah and I feel a lateral strain, and he agreed with me. These are the same bonus docs that approve studies in JAOA.



The key is confidence. Fake it till you make it.

I mean diagnosing. You can't fake diagnosing because proctors do the diagnosis right after you. Miss 1 or 2 little things? Fail. Miss 1 or 2 questions on a medicine test? A +

 

[Petypet]

I mean diagnosing. You can't fake diagnosing because proctors do the diagnosis right after you. Miss 1 or 2 little things? Fail. Miss 1 or 2 questions on a medicine test? A +

Act confident in your diagnosis and they will just agree with you. No joke, I made up 90% of my stuff and I always got it right, and I think it was because I come off as being confident.

 

[wjs010]

Act confident in your diagnosis and they will just agree with you. No joke, I made up 90% of my stuff and I always got it right, and I think it was because I come off as being confident.

I was. Always am actually. That doesn't fly at my school. Proctors literally palpate and check the diagnoses right after each student. If you're diagnosing cervical and put that c-0 is rotated left and the proctor gets right, you fail. Not to mention having to complete the rest of cervical ( c1-c7) without a single mistake.

 

[WingedOx]

Incorrect. Again, "no" evidence has a specific meaning.

weak evidence and no evidence may as well be the same thing. sorry.

 

[GUH]

weak evidence and no evidence may as well be the same thing. sorry.

No; they are not the same thing.

 

[burritowithgreensauce]

1999 and its low back pain. what can conventional medicine do for that? not much. show me massaging a mesentery or something where there's actually a conventional alternative besides rest

u bring up great points and valid criticism regarding omm, but please realize that saying, "show me this. show me that" is a very lazy approach to medicine. i could easily show you a publication that says one thing. Just like you could show me an article that says the exact opposite thing. If you really want to understand something and be able to have weight behind your opinion, whether it's a new drug or - in this case omm - you should be the one reading the articles and coming to your own conclusion.

saying "show me this. show me that." can lead u to a path of ignorance. For example, say the only paper you read about autism was the infamous lancet/vaccines article. if u took this lazy approach to medicine you would undoubtedly believe vaccines cause autism. because hey. it was in the lancet. im not trying to harp on u. all im saying is if u really care that much go find the articles urself. find contradictory articles and come to ur own conclusion. let's not be PAs/NPs about this and just follow some algorithm they teach us.

 

[PL198]

there aren't going to be contradictory articles because of this bullcrap PC nature where we can't openly criticize things that make no sense.

there's been 3 pages of debating its usefulness and the only literature that has been brought up is from 16 years ago, and on dogs. now don't you think if there was promising research, someone would have duplicated it and that research would be easily accessible? they've had 16 years.

 

[hallowmann]

there aren't going to be contradictory articles because of this bullcrap PC nature where we can't openly criticize things that make no sense.

there's been 3 pages of debating its usefulness and the only literature that has been brought up is from 16 years ago, and on dogs. now don't you think if there was promising research, someone would have duplicated it and that research would be easily accessible? they've had 16 years.

I think for LBP its use is promising. The systematic review article I posted earlier had some clearly positive results. The problem is, as is even stated in that article, one of main limiting factors in all of this is funding. They stated that many of the studies they analyzed were self-funded or had limited funding, and as a result had smaller than desired group sizes, concluding ultimately that more studies needed to be done.

Personally, I think that it likely has some efficacy with regards to MSK issues, but you're right in that substantially more research needs to be done. I don't think anyone's disagreeing with that. We just need interested wealthy parties who are willing to fund such research.

For reference if you missed it:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159549/

 

[PL198]

non specific low back pain is literally the worst place to possibly show efficacy though. it's a chronic condition caused by inactive people, plain and simple. nothing that anyone has can really treat that. we can treat the symptoms ( NSAIDs) but there's no treatment because it's just a straight structural problem that develops from tight hip flexors.

I'm not impressed at all that the main validation of OMM occurs through something that the traditional method of treating does little to nothing anyway. show me a real disease process that isn't simply caused by someone's movement patterns, that has an actual allopathic treatment and compare OMM to that. I don't consider NSAIDs a treatment because it's literally just masking the problem which does the patient a disservice IMO.

nonspecific LBP is literally the most wishy-washy medical condition someone can have. give me a concrete illness and a concrete alternative therapy

 

[RadsonRads]

non specific low back pain is literally the worst place to possibly show efficacy though. it's a chronic condition caused by inactive people, plain and simple. nothing that anyone has can really treat that. we can treat the symptoms ( NSAIDs) but there's no treatment because it's just a straight structural problem that develops from tight hip flexors.

I'm not impressed at all that the main validation of OMM occurs through something that the traditional method of treating does little to nothing anyway. show me a real disease process that isn't simply caused by someone's movement patterns, that has an actual allopathic treatment and compare OMM to that. I don't consider NSAIDs a treatment because it's literally just masking the problem which does the patient a disservice IMO.

nonspecific LBP is literally the most wishy-washy medical condition someone can have. give me a concrete illness and a concrete alternative therapy

You won't get what you ask for because it doesn't exist. You would think that after 115yrs of OMM that there would be >1 reputable study on it. Unfortunately (or fortunately, in my opinion) that is not the case

 

[WingedOx]

non specific low back pain is literally the worst place to possibly show efficacy though. it's a chronic condition caused by inactive people, plain and simple. nothing that anyone has can really treat that. we can treat the symptoms ( NSAIDs) but there's no treatment because it's just a straight structural problem that develops from tight hip flexors.

I'm not impressed at all that the main validation of OMM occurs through something that the traditional method of treating does little to nothing anyway. show me a real disease process that isn't simply caused by someone's movement patterns, that has an actual allopathic treatment and compare OMM to that. I don't consider NSAIDs a treatment because it's literally just masking the problem which does the patient a disservice IMO.

nonspecific LBP is literally the most wishy-washy medical condition someone can have. give me a concrete illness and a concrete alternative therapy

To make matters worse the study that @GUH posted selected down to patients with only the mildest symptoms and didn't actually contain a "no treatment" group.

 

[WingedOx]

u bring up great points and valid criticism regarding omm, but please realize that saying, "show me this. show me that" is a very lazy approach to medicine. i could easily show you a publication that says one thing. Just like you could show me an article that says the exact opposite thing. If you really want to understand something and be able to have weight behind your opinion, whether it's a new drug or - in this case omm - you should be the one reading the articles and coming to your own conclusion.

saying "show me this. show me that." can lead u to a path of ignorance. For example, say the only paper you read about autism was the infamous lancet/vaccines article. if u took this lazy approach to medicine you would undoubtedly believe vaccines cause autism. because hey. it was in the lancet. im not trying to harp on u. all im saying is if u really care that much go find the articles urself. find contradictory articles and come to ur own conclusion. let's not be PAs/NPs about this and just follow some algorithm they teach us.

you overall point isn't wrong.

But asking to "show me this" is absolutely appropriate. You analyze the effectiveness of a treatment by "showing me everything." Laying all the data on the table and making judgment based on quality of data, not just the aggrigate quantity. Claiming that just because something is published that quality is assumed is intellectually lazy.

Though the true believers will likely never be swayed.

 

[GUH]

you overall point isn't wrong.

But asking to "show me this" is absolutely appropriate. You analyze the effectiveness of a treatment by "showing me everything." Laying all the data on the table and making judgment based on quality of data, not just the aggrigate quantity. Claiming that just because something is published that quality is assumed is intellectually lazy.

Though the true believers will likely never be swayed.

And the DOs who hate their profession will likely never be swayed, even by established clinical guidelines and publications in respected journals, which they will accept articles from unless the article doesn't follow their preconceived (incorrect) notions about OMM and its usefulness.
They will continue to hold out and wait for a repeat of the 1960's California merger, shouting about quackery and how horrible it is to teach OMM to medical students while everybody else ignores them, and it will never come. They will never be MDs no matter how hard they try to destroy their own profession.

 

[GUH]

You won't get what you ask for because it doesn't exist. You would think that after 115yrs of OMM that there would be >1 reputable study on it. Unfortunately (or fortunately, in my opinion) that is not the case

I like your shifting goalposts. Exactly how much evidence is enough for you now?

 

[TankTuck]

non specific low back pain is literally the worst place to possibly show efficacy though. it's a chronic condition caused by inactive people, plain and simple. nothing that anyone has can really treat that. we can treat the symptoms ( NSAIDs) but there's no treatment because it's just a straight structural problem that develops from tight hip flexors.

I'm not impressed at all that the main validation of OMM occurs through something that the traditional method of treating does little to nothing anyway. show me a real disease process that isn't simply caused by someone's movement patterns, that has an actual allopathic treatment and compare OMM to that. I don't consider NSAIDs a treatment because it's literally just masking the problem which does the patient a disservice IMO.

nonspecific LBP is literally the most wishy-washy medical condition someone can have. give me a concrete illness and a concrete alternative therapy

Here we go! That bolded sentence is the reason why I want to learn to treat with my hands and not rely on pharmaceuticals. Many drugs (not just NSAIDs) do not target the cause of the disease, they target the effects, masking the symptoms (however, it is a little rediculous to completely disregard NSAIDs as a treatment). The side effects can be far reaching and are less than understood. In OMM you are taught to target the cause, not just focusing on subjective symptoms. That's the philosophy at least. And yeah, this is simplistic, but I had to bring it up. I'll say it again, the results in the real world (the actual ability to treat Patients effectively) speaks for itself and is the reason many patients actively seak OMM. OMM is here to stay. If you are so set on the discontinuation of the practice, why don't you show me reputable evidence on how it is damaging to the patient. Managing pain with OMM has little if not side effects. Morphine on the other hand...

http://www.westernupcc.com/docs/omm_scientific_evidence.pdf

Here is a collection of the summaries of some studies on OMM. I didn't have a lot of time, so I only read the summary and haven't researched each specific study. Take it for what you will. I am sure five of you are excited to disprove or discredit each one. I am not assuming quality, I just think it's a relavent read.

 

[Dharma]

Sometimes THE best treatment is addressing symptoms. It may not the the ideal approach, but that's only because ideal is sometimes unrealistic. OMM should be a first line treatment for pain IMO. That said, first line will not cut the muster for a good portion of patients, necessitating the use of a pharmacological or surgical approach. Medicine is rarely a black-white type of thing… most of it exists within the gray zone, contrary to the expectations of the typical medical student.

To me the "osteopathic" approach is simple good medicine. Think whole. Look at the big picture. Always keep benefit vs. risk at the front of one's mind. Stay observant and as objective as possible. Be realistic. Oh… and use your hands… whether it's OMT or physical exams… touch your patients.

In that regard, the "osteopathic" philosophy is most certainly alive. Some take to another level with high level of OMT skills that gets results (pain reduction with decreased need for medication). But yeah… it's out there.