Forbes Osteopathic Medicine Article

[libertyyne]

Pseudoscience claims to use the scientific method. I do not think the scientific method could encapsulate something so organic and individualized. You sound like people discussing psychology in the 18th century. Mental illness exists. Pain exists. Sorry people aren’t so easy to study.

So what you are saying is that it is outside the realm of science. Then why give this preference over faith healing, crystals, magnets, homeopathy?

---

Members don't see this ad.

 

[cryhavoc]

How do you feel about homeopathy?

If the preparations are made as they are in practice and do not cause a benefit, I agree it is pseudoscience. I have read dozens of studies on OMT and not one has replicated how it actually is used.

 

[Osminog]

Pseudoscience claims to use the scientific method. I do not think the scientific method could encapsulate something so organic and individualized. You sound like people discussing psychology in the 18th century. Mental illness exists. Pain exists. Sorry people aren’t so easy to study.

You're rejecting the possibility of applying the scientific method to OMM at all? You've now moved away from the realm of homeopathy and into the realm of faith healing.

 

[cryhavoc]

So what you are saying is that it is outside the realm of science. Then why give this preference over faith healing, crystals, magnets, homeopathy?

Because it is directly targeting the thing it is treating. And it does not claim to cure anything. And does not reccomend the patient cease other forms of treatment.

 

[libertyyne]

If the preparations are made as they are in practice and do not cause a benefit, I agree it is pseudoscience. I have read dozens of studies on OMT and not one has replicated how it actually is used.

how are you ignoring studies performed by DO's ? they were involved in it, its not like an MD went in there and made them not do OMM.

 

[libertyyne]

Because it is directly targeting the thing it is treating. And it does not claim to cure anything. And does not reccomend the patient cease other forms of treatment.

So does faith healing, magnet healing, homeopathy, accupuncture, lasers etc.

 

[cryhavoc]

You're rejecting the possibility of applying the scientific method to OMM at all? You've now moved away from the realm of homeopathy and into the realm of faith healing.

I’m not saying it is impossible, I’m saying you aren’t going to get funding for anything so painfully specific and non-lucrative. I’m certainly not devoting my life to proving anything. My number one concern is helping people, not furthering science.

 

[Osminog]

If the preparations are made as they are in practice and do not cause a benefit, I agree it is pseudoscience. I have read dozens of studies on OMT and not one has replicated how it actually is used.

Many of the patients claim that homeopathic medications helped them, and homeopaths can pass along plenty of incredible anecdotes. Maybe the scientific method isn't well-suited to study the incredible effects of "water memory." Why are you so quick to dismiss homeopathy?

 

[cryhavoc]

So does faith healing, magnet healing, homeopathy, accupuncture, lasers etc.

If that is actually the case, and they aren’t just relying on Jesus or the crystals to cure their cancer, I would never reccomend a patient cease doing something that brings them comfort. And if I felt their faith would bring them greater relief, I would recommend it without a moment’s hesitation. We’ll see if the hospital ethics boards will persecute me for telling a patient it is alright to pray or be visited by a priest during their chemo.

You can stick to your chemo only method if you love science more than you love the patient. I’m sticking to my holistic guns. It isn’t just a random lecture to me like it seems to be to you. It is a philosophy I subscribe to. It produces better outcomes and quality of life, and appreciates the individual.

 

[libertyyne]

If that is actually the case, and they aren’t just relying on Jesus or the crystals to cure their cancer, I would never reccomend a patient cease doing something that brings them comfort. And if I felt their faith would bring them greater relief, I would recommend it without a moment’s hesitation. We’ll see if the hospital ethics boards will persecute me for telling a patient it is alright to pray or be visited by a priest during their chemo.

You can stick to your chemo only method if you love science more than you love the patient. I’m sticking to my holistic guns.

So let me get this straight you would recommend crystal healing to your patients even if they weren't into crystal healing?

You are conflating treatment options with personal belief systems of patients. Of course patients can do what ever brings them joy. I am not going to say that they we have evidence that they are efficacious. I am not going to go around telling them that their faith is the only way to obtain relief from their ailment .

 

[Neopolymath]

This thread is silly for a variety of reasons. A big part of the issue is that we didn't go to medical school to do physical therapy so they should probably stop teaching physical therapy and let, idk, physical therapists practice that while we practice medicine. Simplistically, that is what is going on in DO schools. It should be post-graduate training if it should even exist at all.

Also, even if you say that we don't know how some particular treatment works, we know clinically that it does in fact actually work via sound statistical analysis. The same cannot be said for most of OMM that has neither a real, proven mechanism OR data showing that it works at all regardless of the underlying mechanism.

 

[Neopolymath]

So let me get this straight you would recommend crystal healing to your patients even if they weren't into crystal healing?

You are conflating treatment options with personal belief systems of patients. Of course patients can do what ever brings them joy. I am not going to say that they we have evidence that they are efficacious. I am not going to go around telling them that their faith is the only way to obtain relief from their ailment .

Don't argue with this guy. He is out there lately lol.

 

[cryhavoc]

If that is actually the case, and they aren’t just relying on Jesus or the crystals to cure their cancer, I would never reccomend a patient cease doing something that brings them comfort. And if I felt their faith would bring them greater relief, I would recommend it without a moment’s hesitation. We’ll see if the hospital ethics boards will persecute me for telling a patient it is alright to pray or be visited by a priest during their chemo.

You can stick to your chemo only method if you love science more than you love the patient. I’m sticking to my holistic guns. It isn’t just a random lecture to me like it seems to be to you. It is a philosophy I subscribe to. It produces better outcomes and quality of life, and appreciates the individual.

So let me get this straight you would recommend crystal healing to your patients even if they weren't into crystal healing?

You are conflating treatment options with personal belief systems of patients. Of course patients can do what ever brings them joy. I am not going to say that they we have evidence that they are efficacious. I am not going to go around telling them that their faith is the only way to obtain relief from their ailment .

If you ever get bored “helping people”, you’d be a “great” journalist or politician. I’m out. Blatantly being misinterpreted is my que to leave.

 

[libertyyne]

If you ever get bored “helping people”, you’d be a “great” journalist or politician. I’m out. Blatantly being misinterpreted is my que to leave.

Thanks I expect your vote, and a prescription for some sweet crystal healing.

 

[cryhavoc]

Thanks I expect your vote, and a prescription for some sweet crystal healing.

Try not to tear up the constitution too much. Remember, just because you don’t share someone’s beliefs doesn’t mean those beliefs aren’t important and beneficial to them.

 

[W19]

Could you imagine? This particular treatment only works on 47 year old waitress who worked on a farm as a kid and have these genetics markers and this particular psychology? You could never find studies of that nature.

You may want a “cure all” but cure alls just don’t exist.

Not every injury is the same. Not every patient is the same age or been through the same physical events in life. Every body is different. Thus you could never gather a sample size that allows you to definitely perform the same technique on the same type of person.

I view it like psychology. Does not mean it is illegitimate, it means that you cannot study it in such a manner.

And as it helps alleviate the problem, I view it as a legitimate course of action.

This is not a good defense because you can say that for virtually every single study...

 

[AnatomyGrey12]

If there studies indicating it doesnt work better than placebo, How is doing it to your patients not a performance of placebo?

First, I want to state that I have no idea what that other guy is going on about. He’s gone way beyond my point.

Second, does it matter if it’s a placebo? Say you’re a FM doc and someone with lower back pain sever enough that it limits their ability to work comes to you, you’re going to go straight to surgery (which itself has minimal evidence proving its efficacy) or opioids? You wouldn’t do 5 minutes of manual therapy that has the potential to make them feel better, placebo or not? Yeah it’s anecdotes but patients actually like OMM and I can give you dozens of names of people that swear by it for their MSK issues. I’ve literally met people who stopped taking their chronic pain drugs because they liked it so much. They come to our free OMM clinic every week. I don’t care if it’s a placebo or not, if it makes them feel better enough to keep going to work and not have to take opioids then you bet I’m going to do it or refer them to someone who will.

There is a reason that a number of MDs in FM learn OMM, it’s becuse patients like it and feel like it helps them.

A big part of the issue is that we didn't go to medical school to do physical therapy so they should probably stop teaching physical therapy and let, idk, physical therapists practice that while we practice medicine. Simplistically, that is what is going on in DO schools. It should be post-graduate training if it should even exist at all.

I agree that OMM really has no place in a medical school setting and is much better served incorporated as an elective in residency.

 

[cryhavoc]

This is not a good defense because you can say that for virtually every single study...

Yeah, you are right about every study isn’t encapsulating the individual properly. There are no one size fits all in medicine. We do one size fits all often because our scientific method is not sophisticated enough with current methods or because we simply don’t have the proper funding.

“In general, compared to whites, blacks respond well to diuretics and calcium channel blockers and less well to β-blockers and ACE inhibitors. The exact mechanisms that contribute to differences in blood pressure between blacks and whites are still not fully understood . . . “

Differences in hypertension between blacks and whites: an overview

You don’t need to be a prophet to realize the future of medicine will include individualized treatments. Why should we assume physical therapy is different? When I had shoulder pain, one technique was useless on me and another completely relieved the pain. And if it is the opposite for someone else, why would it automatically mean placebo effect? Couldn’t my body, type of injury, etc. just be different and respond differently?

Why be so quick to dismiss that? We don’t know “why” but we also only have theories on why some medications work better on some individuals. Plus how do you explain all the cancer and autoimmune drugs that “just work” even though we can’t explain why? Probably genetics varying. We just aren’t sophisticated enough to prove it yet, doesn’t mean it isn’t real. And it does not stop us from using these treatments regularly. How “unscientific”.

 

[Neopolymath]

Try not to tear up the constitution too much. Remember, just because you don’t share someone’s beliefs doesn’t mean those beliefs aren’t important and beneficial to them.

And this right here is why we live in a post facts world! No matter what your beliefs are, they are important and should be protected (even if they are unproven or just plain wrong)! This is also the downfall of journalism (besides laziness and lack of integrity). Not everything deserves an equal voice from both sides. OMM is no different. It's time to stop letting koolaid drinkers talk via their AOA mouthpiece and making the rest of us look bad.

 

[cryhavoc]

And this right here is why we live in a post facts world! No matter what your beliefs are, they are important and should be protected (even if they are unproven or just plain wrong)!

See my previous post, a lot of medical treatments are theories masquerading as facts. The reality is we just don’t know.

 

[Neopolymath]

See my previous post, a lot of medical treatments are theories masquerading as facts. The reality is we just don’t know.

So because there are other areas of medicine that need improvement (eg some surgery) that means that OMM gets a free pass? And as I said before, at least when we don't know how/why something works in other areas of medicine we still have some sort of study showing that it does in fact work. Most areas of OMM have neither a proven mechanism or actual proof that it works in general.

When someone says why not do it because it takes 5 minutes and is generally safe, I say go for it even if it should be something learned as a graduate, but you have not said any argument in this thread like that.

 

[sab3156]

If this is the type of person the AOA is filled with (someone with blind trust in OMM even with plenty of evidence showing it has no efficacy beyond that of a placebo), it is no wonder why this organization produces basically zero credible research and (I really hate to say it) simply rides on the accomplishments and breakthroughs of ACGME academic institutions. Really frustrating to see any medical student or physician trying to justify sham treatments. This is the 21st century - I would think DOs could be far beyond talking about AT Still and his magic tricks.

 

[cryhavoc]

AKA there really is more than one philosophy to being a healer and that bothers people.

I honestly think that it helps people with chronic pain and musculoskeletal complaints from anecdotal observation. I don’t need expensive research to confirm what my eyes see.

And I’m also a big supporter of physical therapy after injuries. I never missed how quickly athletes with dedicated teams recover.

All those “crazy witch-doctor” claims don’t seem too outlandish to me and I don’t lose a wink of sleep over it. I personally won’t even use OMT someday. But I won’t pretend it is a magic trick either.

Someone can’t move and walk around to get their lymph flowing, you move them manually, it flows. Maybe it helps a bit. Obvious physiology that you want your lymph circulating.

Doesn’t take a multi-million dollar study to confirm that for me. Common sense.

 

[Promethean]

I cannot get over how many (accepted) and OMS-0 premeds are leading the charge here to discredit OMM or remove it from our curriculum.

Cranial? Yeah, I am still a skeptic.

But muscle energy, FPR, counterstrain, HVLA... they work. They just do. I had crippling back pain. I could not bend forward to put on my own socks. It went on for weeks of pain and restricted motion. One session of OMT and I was pain free and fully mobile. There was no need to come back three times a week for months. Just one treatment. This is just an n of 1, but it was pretty powerful evidence for me.

I don't believe in homeopathy, but if I were ever in that kind of pain and a shot of magic water totally fixed it in one dose.... I'd be a fool not to reconsider.

I don't wish pain on anyone, but if you have the opportunity to have OMT done to treat a real somatic dysfunction, you might just change your tune. Or wait until you see patients barely able to climb onto the OMT table and then jumping off it a few minutes later, surprised at how good they feel.

I hate pseudoscience as much as anyone, but arguing against results because you don't like the explanations is just as bad.

 

[jw3600]

Try not to tear up the constitution too much. Remember, just because you don’t share someone’s beliefs doesn’t mean those beliefs aren’t important and beneficial to them.

....did you just make this a constitutional issue?

 

[sab3156]

I cannot get over how many (accepted) and OMS-0 premeds are leading the charge here to discredit OMM or remove it from our curriculum.

Cranial? Yeah, I am still a skeptic.

But muscle energy, FPR, counterstrain, HVLA... they work. They just do. I had crippling back pain. I could not bend forward to put on my own socks. It went on for weeks of pain and restricted motion. One session of OMT and I was pain free and fully mobile. There was no need to come back three times a week for months. Just one treatment. This is just an n of 1, but it was pretty powerful evidence for me.

I don't believe in homeopathy, but if I were ever in that kind of pain and a shot of magic water totally fixed it in one dose.... I'd be a fool not to reconsider.

I don't wish pain on anyone, but if you have the opportunity to have OMT done to treat a real somatic dysfunction, you might just change your tune. Or wait until you see patients barely able to climb onto the OMT table and then jumping off it a few minutes later, surprised at how good they feel.

I hate pseudoscience as much as anyone, but arguing against results because you don't like the explanations is just as bad.

No offense, but we are discussing actual scientific literature, and it's laughable at best to try and counter a systematic review on this topic with a personal anecdote. We are discussing science, not personal feelings and emotions.

 

[AnatomyGrey12]

and it's laughable at best to try and counter a systematic review

Lol a systematic review of only 16 RTC’s where not a single one of the RTC’s have a methodological quality rating of 5, multiple with ratings of 1..., and where 5 of said RTC’s found significant improvement in MSK pain compared to controls. The conclusion of the authors is extremely dubious and does not fit their data presented. The only thing that the review cited above actually confirms is that we need more OMM RTCs with higher methodological quality ratings in regards to MSK treatment.

 

[Chibucks15]

If you don't buy it, then don't use it. It's not hurting the patient so what's it to you? There is not enough strong statistical evidence for or against MSK to make an educated, definitive answer either way, IMO. If there was, insurance would stop paying for it and it would disappear...

While we all know that all the problems of the world are solved in SDN forums...in the end people will use what they want in their own practice. And this forum is in no way going to change a thing .

 

[libertyyne]

Lol a systematic review of only 16 RTC’s where not a single one of the RTC’s have a methodological quality rating of 5, multiple with ratings of 1..., and where 5 of said RTC’s found significant improvement in MSK pain compared to controls. The conclusion of the authors is extremely dubious and does not fit their data presented. The only thing that the review cited above actually confirms is that we need more OMM RTCs with higher methodological quality ratings in regards to MSK treatment.

You linked an article with a total of 16 patients as evidence basis of MET, somehow 16 RCTs isnt sufficent for you?

Here are problems with providing it as a placebo
1.Harm-

http://www.nationalacademyofosteopa...ide Effects of Osteopathic Manual Therapy.pdf
2. Expense - patient has to pay for it.
3. Informed consent, are you telling your patients we have do not have evidence to support its use?
4. Hours training individuals in a techniques that have no basis in science or efficacy could be spent doing science, trying other things that might work.
5. Why not use other therapies that have similar levels of evidence on a daily basis like homeopathy, reiki, magnet healing.
6. Loss of trust in the medical profession, people going to their DO's get OMM done and then people equate the efficacy of all medicine as to what you were doing and avoid care.
7. Encourages dogmatic thinking and use of OMM for stuff like flu prevention in lieu of flu shots, treatment for gerd etc.


OMM will be an interesting aside in the history books. Do you really want to go down as the people who kept on doing OMM even when the evidence kept piling up that it is as good as sham placebo?

 

[libertyyne]

If you don't buy it, then don't use it. It's not hurting the patient so what's it to you? There is not enough strong statistical evidence for or against MSK to make an educated, definitive answer either way, IMO. If there was, insurance would stop paying for it and it would disappear...

While we all know that all the problems of the world are solved in SDN forums...in the end people will use what they want in their own practice. And this forum is in no way going to change a thing .

insurance pays for chiroquacktors. Political lobbying has more to do with reimbursement. Maybe someone reading this forum might change their mind and not go on promulgating therapies with questionable efficacy. That would be a win.

 

[Chibucks15]

insurance pays for chiroquacktors. Political lobbying has more to do with reimbursement. Maybe someone reading this forum might change their mind and not go on promulgating therapies with questionable efficacy. That would be a win.

Good luck on your crusade to end OMM

 

[libertyyne]

I cannot get over how many (accepted) and OMS-0 premeds are leading the charge here to discredit OMM or remove it from our curriculum.

Cranial? Yeah, I am still a skeptic.

But muscle energy, FPR, counterstrain, HVLA... they work. They just do. I had crippling back pain. I could not bend forward to put on my own socks. It went on for weeks of pain and restricted motion. One session of OMT and I was pain free and fully mobile. There was no need to come back three times a week for months. Just one treatment. This is just an n of 1, but it was pretty powerful evidence for me.

I don't believe in homeopathy, but if I were ever in that kind of pain and a shot of magic water totally fixed it in one dose.... I'd be a fool not to reconsider.

I don't wish pain on anyone, but if you have the opportunity to have OMT done to treat a real somatic dysfunction, you might just change your tune. Or wait until you see patients barely able to climb onto the OMT table and then jumping off it a few minutes later, surprised at how good they feel.

I hate pseudoscience as much as anyone, but arguing against results because you don't like the explanations is just as bad.

ignoring the evidence and relying on testimonials is not very good support. I am sure there are amazing testimonials for homeopathy and reiki and magnet healing as well.

 

[Promethean]

No offense, but we are discussing actual scientific literature, and it's laughable at best to try and counter a systematic review on this topic with a personal anecdote. We are discussing science, not personal feelings and emotions.

You could have so easily avoided any requirement to learn OMT. It isn't even too late! The Caribbean schools await you still.

Instead of throwing a tantrum about being exposed to a whole 200 hours of additional education, you could SO easily choose a route that wouldn't inflict such an indignity upon you. But no. It is more rewarding and fun to take a stance on how something you haven't yet experienced needs to be scoured out of a profession that opened its doors to you and is giving you an opportunity to become a physician. By all means, let us know how it works out for you to come in with that giant chip on your shoulder.

 

[Lawpy]

Wait are there studies showing the benefits of OMM? Because all I’m seeing are people using personal anecdotes to make a claim that’s not supported by studies

Also, I’m not sure how any of this discussion illustrates why OMM should be taught in a medical school curriculum? Or even why teach it in medical education at all? Why not just teach OMM to physical therapists?

 

[Promethean]

ignoring the evidence and relying on testimonials is not very good support. I am sure there are amazing testimonials for homeopathy and reiki and magnet healing as well.

The plural of anecdote is not data. I know that better than most and definitely don't need the OMS-0's around here to school me on that.

And yet... if homeopathy were giving those kinds of results, it would be shameful of us to turn our nose up at them. (Instead, we do have mountains of actual data saying that homeopathy and reiki and magnet healing are BS, so continuing to offer these up as similar to OMT is disingenuous.)

I know that my testimonial doesn't mean much to you, because whatever, someone from the internet could claim any kind of thing. But it was very meaningful to me. I came in with healthy skepticism, and saw first hand results that impressed me. And I continue to see them. A patient just this morning in clinic stated that he got more benefit from the OMT that was done for him there than from weeks of muscle relaxants and NSAIDs. His range of motion is outstanding compared to what it was when we saw him last and he is turning down meds. Again... I can't understand why, when there are real patients in front of me having that kind of benefit from something so relatively benign, that I'm supposed to back away from offering them something that is causing measurable improvements in their function and quality of life because a pre-med or pre-clinical med student doesn't believe the data is robust enough for their tastes.

I'd love more research to be done on OMT and its benefits. There is research ongoing. It just isn't respected by people who've already decided that OMT is voodoo. We've already talked about why randomized controlled trials aren't really going to work for OMT. If you don't believe in OMT, don't do it. If you don't think it should be part of your education, don't go to an Osteopathic medical school. The solutions here seem pretty simple to me.

I'm not sure what is up with the perennial self-hating DOs who skulk around these forums wishing that they'd gotten into MD schools. Some of us had options and still wanted to be DOs for reasons that made sense to us. It gets tiresome to see you folks who admit that you aren't where you wanted to be telling us that we need to ditch the thing that we came here to learn to do, because you don't believe in it and no evidence is going to convince you.

 

[AnatomyGrey12]

You could have so easily avoided any requirement to learn OMT. It isn't even too late! The Caribbean schools await you still.

Instead of throwing a tantrum about being exposed to a whole 200 hours of additional education, you could SO easily choose a route that wouldn't inflict such an indignity upon you. But no. It is more rewarding and fun to take a stance on how something you haven't yet experienced needs to be scoured out of a profession that opened its doors to you and is giving you an opportunity to become a physician. By all means, let us know how it works out for you to come in with that giant chip on your shoulder.

They are an MD student.

You linked an article with a total of 16 patients as evidence basis of MET, somehow 16 RCTs isnt sufficent for you?

Bruh you realize I intentionally linked a crappy one because that’s what you do. Your insistence on crappy research astounds me, across multiple threads and on multiple subjects. You also have continuously avoided all of my earlier comments regarding the fact that OMM is exceptionally cheap compared to the price of the other sham treatments we do on a daily basis across the country so why are you so insistent on abolishing OMM? In case you haven’t noticed the country is in an opioid crisis. You would really go directly to prescribing opioids or invasive surgery instead of seeing if 5 minutes of manual therapy could help and prevent them from needing such drastic measures? Get off your high horse.

Will you never refer a patient to PT then? Because, as it turns out, when you manually stimulate tissue or muscles that are sore or injured there is a chance to increase the patients pain? Will you never give any drugs ever because there could be side effects? You sure do like to cherry pick arguments that could easily be applied to just about anything in medicine.

Again, I don’t give a damn about if it’s a placebo or not because if there are patients that have stopped taking opioids or haven’t needed surgery because of some OMM then you bet I’m going to give it a shot before more invasive and life altering methods.

Wait are there studies showing the benefits of OMM? Because all I’m seeing are people using personal anecdotes to make a claim that’s not supported by studies

No because it is essentially impossible to do a good RCT on OMM. You would need to train someone to give sham treatments, but make them believe they were being taught the real treatment. Stuff like cranial is obviously stupid because it isn’t based in known physiology, but MSK stuff simply doesn’t have data to say either way. Anecdote is the only thing we have to go on.

Also, I’m not sure how any of this discussion illustrates why OMM should be taught in a medical school curriculum? Or even why teach it in medical education at all?

It shouldn’t be taught in undergraduate education. However there is a reason that a good number of MDs in fields like FM and Sports med go on to learn OMM, because in that setting it has practicality.

 

[libertyyne]

The plural of anecdote is not data. I know that better than most and definitely don't need the OMS-0's around here to school me on that.

Ad hom, and a wrong one at that. lol.

And yet... if homeopathy were giving those kinds of results, it would be shameful of us to turn our nose up at them. (Instead, we do have mountains of actual data saying that homeopathy and reiki and magnet healing are BS, so continuing to offer these up as similar to OMT is disingenuous.)

The homeopathy data is just as "compelling " as OMT data.

I know that my testimonial doesn't mean much to you, because whatever, someone from the internet could claim any kind of thing. But it was very meaningful to me. I came in with healthy skepticism, and saw first hand results that impressed me. And I continue to see them. A patient just this morning in clinic stated that he got more benefit from the OMT that was done for him there than from weeks of muscle relaxants and NSAIDs. His range of motion is outstanding compared to what it was when we saw him last and he is turning down meds. Again... I can't understand why, when there are real patients in front of me having that kind of benefit from something so relatively benign, that I'm supposed to back away from offering them something that is causing measurable improvements in their function and quality of life because a pre-med or pre-clinical med student doesn't believe the data is robust enough for their tastes.

1. You say you understand how the plural of data is not anecdote, yet you continue you give anecdotes.
2. Another adhom.

I'd love more research to be done on OMT and its benefits. There is research ongoing. It just isn't respected by people who've already decided that OMT is voodoo. We've already talked about why randomized controlled trials aren't really going to work for OMT. If you don't believe in OMT, don't do it. If you don't think it should be part of your education, don't go to an Osteopathic medical school. The solutions here seem pretty simple to me.

1. Another adhom
2.100 + years of practice yet not enough compelling data. There is no reason why randomized control trials would not work for evaluating efficacy. If you claim that this is above scientific testing, then might as well call it voodoo. These are all the same arguments that faith healers, homeopaths, and reiki folks use.

I'm not sure what is up with the perennial self-hating DOs who skulk around these forums wishing that they'd gotten into MD schools. Some of us had options and still wanted to be DOs for reasons that made sense to us. It gets tiresome to see you folks who admit that you aren't where you wanted to be telling us that we need to ditch the thing that we came here to learn to do, because you don't believe in it and no evidence is going to convince you.

If you went to an OM school just to learn osteopathy, good luck to you.
Adhoms adhoms everywhere.

 

[Lawpy]

I'd love more research to be done on OMT and its benefits. There is research ongoing. It just isn't respected by people who've already decided that OMT is voodoo. We've already talked about why randomized controlled trials aren't really going to work for OMT. If you don't believe in OMT, don't do it. If you don't think it should be part of your education, don't go to an Osteopathic medical school. The solutions here seem pretty simple to me.

I think this is the underlying issue. Schools regularly try to improve their curricula for various reasons, yet DO schools seem to have the problem of integrating OMM into their curricula that most students find to be a complete waste of their time.

OMM is already an elective at many schools, and some members rightly suggested to remove OMM from medical school curriculum and make it a specialty in residency or fellowship. Others think OMM is more useful for physical therapy than medicine and shouldn’t be taught in medical education.

However, their suggestions get dismissed and anecdotes are thrown around freely advocating for OMM but failing to explain why it should be taught in a medical school. To me, the reasons for why OMM is still kept in the med school curriculum have little to do with OMM being useful and largely to do with political reasons on AOA/COCA part as old DOs refuse to give up their “unique identity”.

 

[libertyyne]

They are an MD student.


Bruh you realize I intentionally linked a crappy one because that’s what you do. Your insistence on crappy research astounds me, across multiple threads and on multiple subjects. You also have continuously avoided all of my earlier comments regarding the fact that OMM is exceptionally cheap compared to the price of the other sham treatments we do on a daily basis across the country so why are you so insistent on abolishing OMM? In case you haven’t noticed the country is in an opioid crisis. You would really go directly to prescribing opioids or invasive surgery instead of seeing if 5 minutes of manual therapy could help and prevent them from needing such drastic measures? Get off your high horse.

Haha, link a good article then. what you consider "crap data" is better than anything you have presented and is infinitely better then your opinion. Show me the best that OMM has to offer. You could make all naysayers shut up in a second. I am sure blood letting might also have the same level of "evidence " I dont care about OMM. Psuedoscience is not the way to solve an opiod crisis, im sure the reiki healers are just as effective and cheap.

Will you never refer a patient to PT then? Because, as it turns out, when you manually stimulate tissue or muscles that are sore or injured there is a chance to increase the patients pain? Will you never give any drugs ever because there could be side effects? You sure do like to cherry pick arguments that could easily be applied to just about anything in medicine.

I will, atleast they can show some data for faster recovery times, more than I can say for OMM.

Again, I don’t give a damn about if it’s a placebo or not because if there are patients that have stopped taking opioids or haven’t needed surgery because of some OMM then you bet I’m going to give it a shot before more invasive and life altering methods.

Do you give homeopathy a shot as well? Why not save the poor patient some money and tell them to go get a massage.

No because it is essentially impossible to do a good RCT on OMM. You would need to train someone to give sham treatments, but make them believe they were being taught the real treatment. Stuff like cranial is obviously stupid because it isn’t based in known physiology, but MSK stuff simply doesn’t have data to say either way. Anecdote is the only thing we have to go on.

It is not essentially impossible to do an RCT on OMM. they have been done before.

It shouldn’t be taught in undergraduate education. However there is a reason that a good number of MDs in fields like FM and Sports med go on to learn OMM, because in that setting it has practicality.

I bet you there are More DO's abandoning OMM out of school then there are MD's learning OMM.

 

[Chibucks15]

Ad hom, and a wrong one at that. lol.


The homeopathy data is just as "compelling " as OMT data.

1. You say you understand how the plural of data is not anecdote, yet you continue you give anecdotes.
2. Another adhom.

1. Another adhom
2.100 + years of practice yet not enough compelling data. There is no reason why randomized control trials would not work for evaluating efficacy. If you claim that this is above scientific testing, then might as well call it voodoo. These are all the same arguments that faith healers, homeopaths, and reiki folks use.

If you went to an OM school just to learn osteopathy, good luck to you.
Adhoms adhoms everywhere.

I think this is the underlying issue. Schools regularly try to improve their curricula for various reasons, yet DO schools seem to have the problem of integrating OMM into their curricula that most students find to be a complete waste of their time.

OMM is already an elective at many schools, and some members rightly suggested to remove OMM from medical school curriculum and make it a specialty in residency or fellowship. Others think OMM is more useful for physical therapy than medicine and shouldn’t be taught in medical education.

However, their suggestions get dismissed and anecdotes are thrown around freely advocating for OMM but failing to explain why it should be taught in a medical school. To me, the reasons for why OMM is still kept in the med school curriculum have little to do with OMM being useful and largely to do with political reasons on AOA/COCA part as old DOs refuse to give up their “unique identity”.

That is completely correct. But the sentiment still remains...if you are vehemently opposed to learning OMM, as the posters in this thread are, then work harder and go to an MD school. No one forced anyone to go to a DO school. Some people (like myself) see some uses in the MSK stuff in primary care. I could care less about the rest of it. With how much society relies on medications and painkillers, and how much its killing people, if it works even a little bit its worth attempting.

Also, if people are trying to make a real change, don't complain on an anonymous internet forum, go actually do something. Sitting on here spouting how bad it is and how bad DOs are and whatever else accomplishes literally nothing. Its why I love SDN for entertainment, but man it gets old.

And @libertyyne who cares about what people use it. It's there, people have to learn it, and there's countless more tests and nonsense we learn in medical school (both MD and DO) that we never use again. You keep comparing OMM to old treatments that have been proven to be harmful...there is no such link with OMM.

 

[sab3156]

The only thing apparent in this thread is a denial of scientific evidence showing that OMM is just the same as placebo even in MSK treatments. Telling people to go to Caribbean schools if they don't want to learn OMM is just another way to deflect the issue when scientific evidence fails to support your position. Again, we are interested in scientific research, not anecdotes or insults. The literature shows that OMM is a sham treatment. It isn't "self hating" for DOs to finally accept scientific data. On the other hand, it is embarrassing to continue defending something that is essentially the same level of scientific support as homeopathy/naturopathy/voodoo magic. If AOA wholeheartedly supports OMM (recognized as a sham treatment by serious researchers), it is no surprise why this organization has no respect in the medical world.

 

[IsWhat]

The only thing apparent in this thread is a denial of scientific evidence showing that OMM is just the same as placebo even in MSK treatments. Telling people to go to Caribbean schools if they don't want to learn OMM is just another way to deflect the issue when scientific evidence fails to support your position. Again, we are interested in scientific research, not anecdotes or insults. The literature shows that OMM is a sham treatment. It isn't "self hating" for DOs to finally accept scientific data. On the other hands, it is embarrassing to continue defending something that is essentially the same level of scientific support as homeopathy/naturopathy/voodoo magic. If AOA wholeheartedly supports OMM (recognized as a sham treatment by serious researchers), it is no surprise why it has no respect in the medical world.

OMT is not going anywhere. The DO degree may not last forever, but there are enough people (even on the MD side) who practice OMM to keep the treatment modality around. Take away cranial and a few other iffy procedures, and OMM actually becomes quite palatable.

 

[AnatomyGrey12]

and is infinitely better then your opinion

No, crap data is crap data and isn't worth anything.

Haha, link a good article then

I will, atleast they can show some data for faster recovery times, more than I can say for OMM.

Psuedoscience is not the way to solve an opiod crisis, im sure the reiki healers are just as effective and cheap.

Here is an NEJM article showing that the "pseudoscience" you are trying to compare to blood letting and reiki healers has the same outcome as standard medical care with significantly less medication use and less need for PT. Lol if something is shown to be equivalent to standard medical care and requires the use of less pharmacotherapy then yeah sorry but I'm going with that option first before I prescribe drugs or other invasive treatments.

http://www.nejm.org/doi/full/10.1056/NEJM199911043411903

Here is a little quote that I think highlights my whole point, "The osteopathic-treatment group received less medication and less physical therapy than the standard-care group, and the differences in cost were significant. The value of drugs in the treatment of acute pain is supported in controlled trials.29 However, as compared with those who wrote more prescriptions, physicians in managed-care settings — who wrote fewer prescriptions and emphasized education, continued physical activity, and self-care — obtained similar outcomes in terms of pain and function at one year, with lower cost and higher patient satisfaction.30 Given the known and potentially serious adverse effects and costs of nonsteroidal antiinflammatory drug therapy,31,32 the achievement of equal outcomes in regard to pain relief, function, and satisfaction, with less use of medication and physical therapy, suggests an important benefit of osteopathic manipulative treatment; this type of treatment deserves careful examination through a formal cost–benefit analysis."

 

[libertyyne]

No, crap data is crap data and isn't worth anything.







Here is an NEJM article showing that the "pseudoscience" you are trying to compare to blood letting and reiki healers has the same outcome as standard medical care with significantly less medication use and less need for PT. Lol if something is shown to be equivalent to standard medical care and requires the use of less pharmacotherapy then yeah sorry but I'm going with that option first before I prescribe drugs or other invasive treatments.

http://www.nejm.org/doi/full/10.1056/NEJM199911043411903

Here is a little quote that I think highlights my whole point, "The osteopathic-treatment group received less medication and less physical therapy than the standard-care group, and the differences in cost were significant. The value of drugs in the treatment of acute pain is supported in controlled trials.29 However, as compared with those who wrote more prescriptions, physicians in managed-care settings — who wrote fewer prescriptions and emphasized education, continued physical activity, and self-care — obtained similar outcomes in terms of pain and function at one year, with lower cost and higher patient satisfaction.30 Given the known and potentially serious adverse effects and costs of nonsteroidal antiinflammatory drug therapy,31,32 the achievement of equal outcomes in regard to pain relief, function, and satisfaction, with less use of medication and physical therapy, suggests an important benefit of osteopathic manipulative treatment; this type of treatment deserves careful examination through a formal cost–benefit analysis."

Here ,
Spinal manipulative therapy for acute low-back pain. - PubMed - NCBI
Your high quality data is almost 2 decade old study, with no sham treatment or blidning. with only 150 patients. Lol.
"SMT is no more effective in participants with acute low-back pain than inert interventions, sham SMT" Here is the highlight. Try harder.

 

[AnatomyGrey12]

Your study doesn't say what you think it says, I'll let you go back through it and figure out why. Cheers

 

[libertyyne]

Your study doesn't say what you think it says, I'll let you go back through it and figure out why. Cheers

It's clear there is no reasoning with psuedoscience enthusiasts. Cheers.

 

[Neopolymath]

It's clear there is no reasoning with psuedoscience enthusiasts. Cheers.

This isn't in response to any particular post of yours, but I do want to mention that it is also hard to find studies that are clearly about DO OMM and not including chiropractors and osteopaths (a totally separate thing than DO in the rest of the world despite using the same name). You might already know that, but I figured I would point it out to muddy the water even more.

 

[W19]

I would like to say that DO who practice OMT are voodoo doctors, but I won't say that...

 

[jrlob91]

It's clear there is no reasoning with psuedoscience enthusiasts. Cheers.

Maybe you should leave the DO student thread if you don’t like one of the founding principles of the degree? Just a thought.

 

[Mad Jack]

Testimony is literally what homeopaths , chiropractors, magnet healers, faith healers hang their hats on.
The plural of anecdote is not data.

Blaming big pharma is also another common trait of people who have no evidence.

Lack of standardization and lack of agreement among experts is also a hallmark of pseudoscience.

OMM has had over 100 years , still cant show clear superiority to standard of care or sham in good quality studies.

Many medical procedures suffer from the same limitations. Most of non-trauma orthopedics is in the same boat as OMM, for instance, completely statistically either equal to sham or with inadequate quality of evidence to prove that it definitively works. I guess what it comes down to, for me, is that it doesn't matter if it's effective, a placebo, or whatever- I've seen patients that had chronic pain come off of opioids and muscle relaxers after OMT, and that's life-changing. I'm never using OMT in practice, given my field of choice, but I do think it has utility for some patients. The difficulty is identifying the patients that will benefit from the ones that won't, and what techniques work and what don't, but no one is going to fund those studies so they aren't done.