There are some "minor" obstacles in devising good studies to prove the efficacy of OMT. As you will soon realize when you start your first year of OMT, osteopathic diagnoses are somewhat "unconventional".
For instance, take 2 individuals with lower back pain. X-rays are normal. They both have MRIs of their lumbar region and the MRIs show..."nothing", totally unremarkable. So, now what?! Conventionally, you can try muscle relaxants, perhaps check to see if they don't happen to have a shorter leg (more x-rays) but let's say you come up empty handed (after doing all the tests an allopath usually does). These two individuals go to a DO (in this case, probably someone who does a lot of OMT) and this DO may come up with a different diagnosis for each individual. Now, in all areas of medicine, different diagnosis carry their own individual prognosis. The same is true in this case. Individual A may have a diagnosis for his back pain which carries a better response to treatment than individual B (I won't go into details of what they may be right now). So individual A, by the nature of his problem, may be more responsive to OMT than individual B. So, mistakenly, one may argue that OMT is not truly efficaceous because it worked in individual A and not in individual B (1 out of 2). Because the diagnosis was different though, this is not a fair assesment of OMT (it is comparable to saying, individual A has stomach pain and so does individual B. They both receive drug X and individual A gets better but individual B doesn't; without taking into account that A had gas and B had irritable bowel syndrome...).
So, when you do a study on the efficacy of OMT on back pain, you need to get a group of patients and a control group where everyone has the same exact reason for the back pain. Let's suppose, for the sake of the argument, that they all have a backward sacral torsion. Then you are comparing apples to apples so to speak. However, if some of the participants in the study have back pain due to a backward sacral torsion, some due to a posterior innominate rotation and others due to an inflare,for instance, you cannot expect the same outcomes after treatment, as some things are easy to "fix" than others.
Additionally, one of the things you will also learn as a DO student, is that when it is said that DOs treat the patient as a "whole", we are not necessarly referring to the patient mind/body/psychosocial, although this is part of it too. But, as our MD students colleagues have pointed out, so do MDs today. Treating the patient as a "whole", and in this sense unique to osteopathy through its use of OMT, also encompasses the fact that, if a patient comes to you complaining of lower back pain, you may end up finding out that the problem is not in the lumbar back at all, but perhaps in the right shoulder, and you have to work from the right shoulder down, through a series of "links", so to speak, in order to treat the lumbar pain. This is, incidentally, one of the aspects that make OMT so time consuming to practice and not very financially rewarding, in this day and age. To be sure, there are some "quick and dirty" techniques: if you know your patient has carpal tunnel syndrome, for instance, there are techniques you can use on the wrist directly, you don't have to go hunting for something else. But for more vague problems (such as back pain or paresthesias and complete lack of any significant radioimaging findings) it takes a lot of time, work and experience to figure out what is going on and to treat it with OMT(my advice: refer these patients to people who specialize in OMT).
