OMT and Pain Medicine

[docdoc121]

I was more or less destroyed when I asked this question in the Anesthesia forum. It seems as though there is little to no room for OMT in Anesthesia. However, some of them did say that Pain Med can incorporate OMT to some degree. So my question is, do you use ever use OMT in pain medicine? if you do, how often and in which type of cases? if you don't, can you please tell me (politely) if that's due to time restrictions, lack of skill, and/or in-patient settings? i'm attending DO school in the Fall.

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[Ligament]

Yes I personally use OMT in my pain practice. It works great in acute to sub-acute musculoskeletal pain, particularly axial spine pain.

OMT has a very comfortable place in pain medicine, and I'm glad I'm a DO for this reason. I get referrals from physicians for injections and also for OMT!

It does not work so well in the really nasty, chronic pain patient population, and thats when I am happy I have a continuum of force and can move onto injection therapy.

There are other DO pain docs on this forum, some of whom even did an OMT fellowship, and hopefully they will chime in too.

Nobody in our subspecialty uses OMT as as primary tool for our tough patients, but it is very useful to us as part of our toolbox.

 

[painchas]

Excuse the ignorance OMT?

 

[DistantMets]

Osteopathic Manipulative Treatment

I plan to incorporate it into my practice. I agree with Ligament, it's a tool in the bag to offer to patients, and probably better for the acute reaggravations in the chronic pain population. There are a techniques like counterstrain that are easily taught to the patient or family member if they get good short-term relief in the office.

 

[Dr. Ice]

I find that it works quite well for thoracic pain (muscular pain that is) and I often refer patients to my practicing osteopathic manipulator collegues out there (regretfully, I am not one) for these patients. I def think there is a role for counterstrain, and muscle energy.

 

[drvlad2004]

I LOVE using OMT in my spine practice (cervical, thoracic, and lumbar). Most often, I perform HVLA, muscle energy, balanced ligamentous technique, and FPR in the office for a few of my patients. The patients seem to get immediate pain relief and leave the office quite happy.

 

[GMEN]

I would be really careful with the HVLA, esp on the cervical spine. (Pretty good review article.. HVLA thrust techniques: What are the risks?
International Journal of Osteopathic Medicine, Volume 9, Issue 1, Pages 4-12
P. Gibbons, P. Tehan). There are also cases of strokes and hematoma's caused by cervical HVLA. Not worth the 2 hours of "relief" the pt reports IMHO. Im not at all a fan of OMT in chronic pain management. I also don't believe in chiropractic care either. I was a fan during medical school but after having it done on me plenty of time, I feel like it just doenst work and are wasting your time. You can sit and kneed dough for an hour or do a quick trigger point injection to treat myofascial pain? I say the latter.. maybe incorporate some myofascial release techniques during PT, but thats on their time not mine.

 

[SleepIsGood]

I would be really careful with the HVLA, esp on the cervical spine. (Pretty good review article.. HVLA thrust techniques: What are the risks?
International Journal of Osteopathic Medicine, Volume 9, Issue 1, Pages 4-12
P. Gibbons, P. Tehan). There are also cases of strokes and hematoma's caused by cervical HVLA. Not worth the 2 hours of "relief" the pt reports IMHO. Im not at all a fan of OMT in chronic pain management. I also don't believe in chiropractic care either. I was a fan during medical school but after having it done on me plenty of time, I feel like it just doenst work and are wasting your time. You can sit and kneed dough for an hour or do a quick trigger point injection to treat myofascial pain? I say the latter.. maybe incorporate some myofascial release techniques during PT, but thats on their time not mine.

Although I'm not a DO...I've had OMT done to me. I would agree with you in the sense that it provided temporary relief in the one to two hour range, that was it.

 

[SSdoc33]

well, an N=2 is sound basis for medical decision making.....