Poll: Do you believe in OMM?

[softmed]

I'm curious to see how many people entering a DO program (or are interested in one) on this forum actually believe OMM is based on solid science. Or whether they believe science is even necessary.

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[boone95]

I'm curious to see how many people entering a DO program (or are interested in one) on this forum actually believe OMM is based on solid science. Or whether they believe science is even necessary.

Yes. I know it works. Ask my back and neck.

Oh, and there are publications out there that agree as well.

 

[JeetKuneDo]

I hear cranial is up in the air.

 

[softmed]

Yes. I know it works. Ask my back and neck.

Oh, and there are publications out there that agree as well.

I'm talking more about the philosophy of OMM as a whole. There are individual parts similar to physical therapy, and although they remove the science from OMM curriculum, there's good evidence it works. Things like cranio-sacral therapy are a crock though. And overall A.T. Still was making things up when he first started doing manipulations.

Ideas like OMM can boost your immune system or cure any disease/disorder outside the musculoskeletal system is also a crock. They do not have any sort of evidence at all.

But this is just what I believe as a possible future osteopath. I'm skeptical of OMM on the whole, but I have an open mind that the evidence could change or someone could show me new evidence I'm unaware of.

 

[Cybii]

I don't know why this is in the pre-osteo forum. I assume that most of us have never experienced OMM first hand, let alone distinguish whether or not it's biased on science. And even if we have we haven't seen enough of it to really support or refute it.

 

[Daedra22]

I saw a patient who felt better after the doc I was shadowing worked on her, but that is the extent of my experience. I know a number of people who have been helped significantly by chiropracters... I recognize that OMM is different, but it's the only comparison I have. I'm going into DO school with an open and positive mindset. I'm sure that even if they are a lot of unhelpful things, at least some of it must be useful.

 

[softmed]

I don't know why this is in the pre-osteo forum. I assume that most of us have never experienced OMM first hand, and even if we have we haven't seen enough of it to really support or refute it.

But an argument from personal experience is a logical fallacy. First, the procedure has to be grounded in solid science. AT Still was just making things up or guessing. Second, you should be able to see some kind of solid evidence in scientific journals that certain procedures are beneficial to patients (ie, they do better with the OMM than with a placebo procedure).

Even if every patient I perform OMM on thinks they're getting better, that won't change my mind without a solid set of publications showing that procedure actually helps patients.

 

[Everglide]

I actually had OMM performed on me before I knew what a DO or OMM was, it worked for my lower back pain.

Now as for actual "science", there have been some though not a lot of papers published in reputable journals that show its efficacy. I don't know enough about OMM itself (still waiting to start school) to speak towards the science of it.

 

[illegallysmooth]

I don't know why this is in the pre-osteo forum. I assume that most of us have never experienced OMM first hand, let alone distinguish whether or not it's biased on science. And even if we have we haven't seen enough of it to really support or refute it.

It's on pre-osteo bc we're pre-osteo and the mods would move it back if it were posted elsewhere.

 

[Bacchus]

I'm talking more about the philosophy of OMM as a whole. There are individual parts similar to physical therapy, and although they remove the science from OMM curriculum, there's good evidence it works. Things like cranio-sacral therapy are a crock though. And overall A.T. Still was making things up when he first started doing manipulations.

Ideas like OMM can boost your immune system or cure any disease/disorder outside the musculoskeletal system is also a crock. They do not have any sort of evidence at all.

But this is just what I believe as a possible future osteopath. I'm skeptical of OMM on the whole, but I have an open mind that the evidence could change or someone could show me new evidence I'm unaware of.

There are dog experiments that have been done in the past that directly measured lymph flow while doing osteopathic techniques. Flow was found to be heigtened. Since the immune system is directly connected to the lymphatics...you get what I'm trying to say.

Also, there are studies on LBP. The most recent I know of has come out of TCOM. 150 subjects (approx.) with LBP and who were pregnant. Conclusion: OMM works for LBP.

1918 Flu epidemic, as suggested by epidemiological examination of data, suggests that OMM helped curb the flu epidemic in the US. You can search my post history for all the info.

 

[FutureCTDoc]

Whoever wrote the poll did a poor job in doing such. There is no "NO!!!!" option the closest is "No, the science is dubious but I keep an open mind". I am an OMM agnostic. I find the science behind it underwhelming and things like cranial make absolutely no sense whatsoever. The most recent study I read was the UNTHSCOM one on OMM for back pain during pregnancy it had a tiny n, it was 200 and couldn't be double blinded. However I do feel for lumbar back pain there may be some efficacy in general.

 

[Bacchus]

How exactly do you double-blind an OMM study? Have a robot perform the manipulation? Toddlers? Who?

 

[FutureCTDoc]

How exactly do you double-blind an OMM study? Have a robot perform the manipulation? Toddlers? Who?

You can't therefore you will never have the gold standard for research work. Most muscle pain goes away eventually so...

 

[Bacchus]

Eventually? So if pain goes away after weeks, months, years the agony means nothing? You argued this with medical students and residents before whom all disagreed with you and said the study showed as much promise as it could along with the effectiveness of OMM (not all inclusive). You haven't started school yet; its dangerous to make an opinion on something you haven't learned yet.

 

[FutureCTDoc]

Eventually? So if pain goes away after weeks, months, years the agony means nothing? You argued this with medical students and residents before whom all disagreed with you and said the study showed as much promise as it could along with the effectiveness of OMM (not all inclusive). You haven't started school yet; its dangerous to make an opinion on something you haven't learned yet.

You apparently miss the point. Irrespective of an OMM intervention muscle pain goes away. The question is whether OMM makes it go away quicker and I'm unconvinced on that front. I love how you appeal to credentials as being the basis of dismissing my comment.

 

[Bacchus]

I could say, it does go away, based on experience in lab and life, but like those arguments presented before this, you did not want to listen to experienced individuals.

 

[Drrrrrr. Celty]

Meh I've never studied OMM/OMT but in theory it sounds applicable. The body is not a brick and it can be stimulated in many a way to create a response. It's without a doubt that OMM can stimulate immunity responses or help the body along with this.
I suppose that there is little evidence, but I'm going to say that if Mark Twain supported OMM because of seeing its usefulness ( a DO saved a family member of his by using manipulation to flush her lungs) and then defending the DO medical model. Then I support OMM .

 

[JaggerPlate]

Wrong sub forum to ask this question. It's kind of impossible for any of us to say we believe or don't believe in it yet. I'm super eager to learn it, if that means anything. However, I've never had it done on me ... sooo yeah.

 

[MalachiConstant]

I guess I need to read more of the research to decide whether or not OMM is based in solid science. That said, my personal experiences with it and chiropractic are enough to convince me that it's use is warranted, and I plan to use it in my future practice. Even if it's just a placebo effect, if it makes people feel better, to me, it's worthwhile.

MC

 

[JaggerPlate]

I guess I need to read more of the research to decide whether or not OMM is based in solid science. That said, my personal experiences with it and chiropractic are enough to convince me that it's use is warranted, and I plan to use it in my future practice. Even if it's just a placebo effect, if it makes people feel better, to me, it's worthwhile.

MC

I agree with a lot of what you said, but I wouldn't lump it in with chiro.

 

[softmed]

I agree with a lot of what you said, but I wouldn't lump it in with chiro.

Chiropractic shares many of the same philosophies as OMM. Lumping them together is pretty fair.

(although it wouldn't be fair to lump DO and DC, they're very different professions and degrees, and the latter dabbles in pseudoscience to a much, much greater degree)

 

[Semicolon]

This is definitely in the wrong forum. Pre-meds have never even stepped into an OMM lab (except maybe during an interview tour). You seriously need to experience it for yourself before you form an opinion on it.

 

[JaggerPlate]

Chiropractic shares many of the same philosophies as OMM. Lumping them together is pretty fair.

(although it wouldn't be fair to lump DO and DC, they're very different professions and degrees, and the latter dabbles in pseudoscience to a much, much greater degree)

This is pre-med arguing pre-med here ... we've never taken one OMM class, so this argument is pretty worthless. However ... I still think you're wrong.

Chiropractic builds its philosophy, with regards to manipulation, upon spinal alignment as the crux of total body wellness. Fix the spine ... fix the problem. However, it's my understanding that the diagnosis and adjusting of the spine isn't as precise and subtle as OMM.

OMM uses a variety of Neuromusculoskeletal techniques, not just spinal manipulation. HVLA (high velocity low amplitude) is the technique that is comparable to chiro ... but, again, it's my understanding that DCs use high velocity on a much larger range of motion and do less diagnosis. However, OMM also utilizes a variety of other MSK manipulation techniques, not related to spinal manipulation.


** note to all med students ... if I butchered that, I am sorry. I'm a pre-med, and accept that - feel free to correct at will.

 

[MalachiConstant]

I didn't mean to insinuate parity between OMM and chiropractors. I feel OMM is much more robust as a field and chiropractic does tend to lean a bit on pseudoscientific evidence.

I have, however observed many people who are just thrilled with chiropractic treatment. I think it's something that could be capitalized on by many DO's. Personally, even if research data didn't support the effectiveness of manipulation, I would be inclined to use it because I've seen that for many patients, it provides the perception of improvement which leads to a greater degree of trust, thus improving the patient/physician relationship, which ultimately allows you to provide higher quality care. I guess I see the benefits of OMM as potentially twofold; the possible direct improvement of symptoms from treatment, and the psychological benefits derived from actually receiving some sort of treatment as opposed to leaving the office with the same problem and a script for narcs to just mask the symptoms.

MC

Edit: I have both seen and experienced OMM treatments myself as well as having observed (and been treated by) a chiropractor for a significant amount of time. Also, I'll note the caveat that I too am a pre-med who's yet to actually sit through an OMM class, so my opinions are based on observations of others clinical practices.

 

[NerdyAndrea]

I've done a lot of physical therapy massage, there are relese fo the spine using the abdominal muscle. You can massage the diaphragm, and help with breathing and circulation. Lot's of stretching and gentle soft tissue manipulation. I have often wondered if this has more similarity to OMM than Chiro.

I have no way of knowing yet. I do know that I can feel when tissues open, or a muscle lets go, or a pain referral point relaxes. It's a great feeling underneath your hands. I love doing palpation and watching people to check their gait, and just get a good general physical anaysis, I always found SOAP chartng a blast too (though I'm probably crazy)

I am thinking that one day I can combine the massage and OMM. I enjoy the physical medicine portion of things too. It's somethinI think about at times.

A

 

[Siggy]

How exactly do you double-blind an OMM study? Have a robot perform the manipulation? Toddlers? Who?

Have both the treatment and the control technician not be physicians. You train the treatment technician in the appropriate technique and the control technician in a placebo technique. Since both technicians think that their treatment is the correct treatment, you now have a double blind method of treatment.

 

[Siggy]

But an argument from personal experience is a logical fallacy. First, the procedure has to be grounded in solid science. AT Still was just making things up or guessing.

Just making sure you know, there are plenty of things done in medicine that aren't really rooted in science. It's an issue with medicine, not any specific philosophy.

 

[group_theory]

I'm talking more about the philosophy of OMM as a whole. There are individual parts similar to physical therapy, and although they remove the science from OMM curriculum, there's good evidence it works. Things like cranio-sacral therapy are a crock though. And overall A.T. Still was making things up when he first started doing manipulations.

Ideas like OMM can boost your immune system or cure any disease/disorder outside the musculoskeletal system is also a crock. They do not have any sort of evidence at all.

But this is just what I believe as a possible future osteopath. I'm skeptical of OMM on the whole, but I have an open mind that the evidence could change or someone could show me new evidence I'm unaware of.

You have a lot of misconceptions about osteopthic medicine and OMM. And you have also made conclusions based on those misconceptions.

I'm sure there are other premeds who also have misconceptions of what osteopathic medicine and OMM is too. So doing a poll on the validity of OMM to a bunch of premeds is an exercise in futility.

And do you seriously think that structure and functions are not interrelated and that alteration of one can affect the other? That's one of the underlying tenets of osteopathic medicine.

 

[Bacchus]

Have both the treatment and the control technician not be physicians. You train the treatment technician in the appropriate technique and the control technician in a placebo technique. Since both technicians think that their treatment is the correct treatment, you now have a double blind method of treatment.

I'd say that's dangerous. I also think consistency would be lost. Who knows.

 

[faith2]

I believe that OMM feels good I had it done several times by the DO I shadowed and some DO students. I do not agree with the correlation to its affects on certain illnesses.

 

[DocHomer]

I'm somewhat excited to learn OMM, but the way the question is phrased makes me worry about how it's perceived. It shouldn't be an article of faith but rather it should be based on science. In other words, you shouldn't have to "believe" in it. I realize that it's hard to have studies testing its efficacy, but I hope the science behind it grows and the practice becomes more mainstream.

I haven't started med school yet, so my knowledge is undoubtedly limited.

 

[Siggy]

I'd say that's dangerous. I also think consistency would be lost. Who knows.

It's not that hard to fake a treatment, especially if the patient doesn't know what the correct treatment is.

 

[bleeker10]

Just making sure you know, there are plenty of things done in medicine that aren't really rooted in science. It's an issue with medicine, not any specific philosophy.

Yea many times I have heard a prof tell us they don't know why something works and research hasn't shown how it works, but clinical results show it to work. One of my profs today said they don't know why central lesions cause vertical nystagmus, but clinical results show it to be true. And he is the head of the acoustic research lab here and works with the vestibulocochlear system as part of his research. Many times we do things because we have been told in the past that it works.

 

[Siggy]

Exactly. One of my favorite medical myths is the trendelenburg position. The only thing that trendelenburg has been shown to increase is shortness of breath and intercranial pressure.

 

[willen101383]

Am I the only person who thinks this way?? But if your goal as a physician is to relieve a patients pain and suffering...and you perform OMM on them....and to them it is relieving pain.....have you not just done your job as a physician???

The only way I can see this being unethical is if you market OMM to your patients as being able to do things it hasnt been proven to do. But if you offer to try it on patients and state that it *MAY* help them not *WILL* help them...i really see nothing wrong with that.

Who knows if OMM is placebo effect...and lacks studies to back its efficacy. But you know what? Placebo effect or not, the placebo effect IS well documented in studies and it does work!

 

[Bacchus]

Am I the only person who thinks this way?? But if your goal as a physician is to relieve a patients pain and suffering...and you perform OMM on them....and to them it is relieving pain.....have you not just done your job as a physician???

The only way I can see this being unethical is if you market OMM to your patients as being able to do things it hasnt been proven to do. But if you offer to try it on patients and state that it *MAY* help them not *WILL* help them...i really see nothing wrong with that.

Who knows if OMM is placebo effect...and lacks studies to back its efficacy. But you know what? Placebo effect or not, the placebo effect IS well documented in studies and it does work!

A lot of people don't think this way. They should, but they don't. You don't have to put all your vested interest into OMM, but realize that if it makes the patient feel good, along with other therapies to manage/control/eradicate the condition it can be used. Do enough DOs use it (that can make it practical for their specialty)? No. That's a whole other debate though.

 

[willen101383]

A lot of people don't think this way. They should, but they don't. You don't have to put all your vested interest into OMM, but realize that if it makes the patient feel good, along with other therapies to manage/control/eradicate the condition it can be used. Do enough DOs use it (that can make it practical for their specialty)? No. That's a whole other debate though.

It blows my mind. For example, chiropractic is generally considered BS by the medical community....but look at how many people utilize/swear by their treatments!!

I have never had OMM/chiropractic performed on myself, but I have received professional massages after sports injuries...and after the massage the pain tightness level is significantly gone. So while that masseuse may not have been working under published research, they sure as hell fulfilled their job as a masseuse by making me injured area feel better!

 

[JaggerPlate]

Like everything in life ... there exists the good and the bad. There are good docs and bad docs, good teachers and bad teachers, and there are good DCs and bad DCs. Some are nutty, and shun modern medicine to the point of absurdity. Others, who are also bad, want to take over the field of primary care with the current amount of training they have, which, to my understanding, is not comprehensive enough (by a long shot). However, there are people who are good DCs ... who believe in spinal manipulation, and like working with herbal stuff and vitamins. They don't deny modern medicine, and they don't try to sell themselves as something they aren't. Facetguy (a member of SDN) may chime in later ... he's one of the goodin's I was describing.

However ... I've had bad experiences with chiro in general, and won't seek their care out anytime soon. I also don't think it should be lumped in with OMM.

 

[FutureCTDoc]

It blows my mind. For example, chiropractic is generally considered BS by the medical community....but look at how many people utilize/swear by their treatments!!

I have never had OMM/chiropractic performed on myself, but I have received professional massages after sports injuries...and after the massage the pain tightness level is significantly gone. So while that masseuse may not have been working under published research, they sure as hell fulfilled their job as a masseuse by making me injured area feel better!

The fact that many people swear by something means nothing. Remember what your mother used to say, "If all your friends jumped off a bridge would you do it?". That's the same argument that you use, if a lot of people do it then it must be right.

 

[JaggerPlate]

The fact that many people swear by something means nothing. Remember what your mother used to say, "If all your friends jumped off a bridge would you do it?". That's the same argument that you use, if a lot of people do it then it must be right.

Eh, I disagree and agree at the same time: 1. You're right, it isn't good science, but 2. If it's helping patients mentally, physically, etc, and you aren't exploiting them or selling them on something it isn't going to cure, or telling them to avoid proven treatments in place of OMM, etc, then it's not really comparable to 1950, colloquial catch-phrases. That, to me, robs OMM of the idea that it can do some good for patients (whether or not it sets a good precedent or follows good science).

 

[willen101383]

The fact that many people swear by something means nothing. Remember what your mother used to say, "If all your friends jumped off a bridge would you do it?". That's the same argument that you use, if a lot of people do it then it must be right.

It means that you are being an effective physician in my opinion. We can agree to disagree..that is fine. Its just my opinion that as long as you inform patients that the OMM treatment MAY help not WILL help...and are open with them about the limitations of OMM you are not acting unethically. If every single treament in medicine must comply completely with the scientific method than of course OMM would be disallowed. But that is why medicine is an art AND a science. The placebo effect essentially means that although the given treatment may not directly cause an amelioration of symptoms...there is a perceived effect by the patient. I am not up to snuff on the actual studies pertaining to the placebo effect...but IIRC the placebo effect does genuinely trigger the expected response somehow...its not always in the patients head. (this assumes OMM provides relief through a placebo effect, and not through a genuine therapeutic method)

 

[willen101383]

The fact that many people swear by something means nothing. Remember what your mother used to say, "If all your friends jumped off a bridge would you do it?". That's the same argument that you use, if a lot of people do it then it must be right.

and to clarify, I was using the example of so many individuals using DCs to hint that although chiropractic may be a pseudoscience...many many people think their treatments work. And if you think a treatment works and your symptoms are relieved....thats as good as gold in my opinion.

 

[softmed]

Just making sure you know, there are plenty of things done in medicine that aren't really rooted in science. It's an issue with medicine, not any specific philosophy.

Name one. Even if they're not fully tested with a double blind study, they're firmly rooted in known science and often have previous studies leading us to believe they'd work. For example, the flu vaccine.

Even if there are no previous studies on humans, there are often studies on other animals. It's always scientifically plausible. And after the procedure has been done enough times, it's always compared to the standard of care in a retrospective study to look at benefits. This isn't true with many procedures and claims of OMM (especially cranial osteopathy and claims like "boosts your immune system*/metabolism/whatever").

There are dog experiments that have been done in the past that directly measured lymph flow while doing osteopathic techniques. Flow was found to be heigtened. Since the immune system is directly connected to the lymphatics...you get what I'm trying to say.

I get what you're trying to say, but your reasoning doesn't make sense. You're making many unfounded assumptions:

1. that the increased lymph flow is more than temporary
2. that increased lymph flow = better functioning immune system
3. that the results will translate to humans (probably the smallest problem with your assertion)

At best, the study would be hypothesis generating. I could never recommend it to a patient having trouble with their immune system unless some kind of experiment confirmed they might benefit.

And do you seriously think that structure and functions are not interrelated and that alteration of one can affect the other? That's one of the underlying tenets of osteopathic medicine.

This is what's known as "a straw man argument". You've misrepresented my position so you can break it down. I never said structure and function aren't related. What you've said is similar to if a homeopath claimed "mainstream doctors tell us that the matter and energy in our cells do not interact." It's a total misrepresentation of my position.

I'm saying claims about homeostasis, boosting immune system, and metabolism (things that aren't really testable) are nonsense claims. Certainly it's plausible that OMM has some benefit to the musculoskeletal system, especially since science based medicine has duplicated some of the techniques for physical therapy. But this doesn't make all the claims that fall under the umbrella of OMM true.

 

[Bacchus]

OMM lecture is pointless .

 

[JaggerPlate]

OMM lecture is pointless .

What about OMM lab???

 

[bleeker10]

OPP lab is where you will learn everything. I never pay attention in lecture but since I pay attention in lab and practice everything they teach us, I do well in the class. It seemed at first that lab took time away from studying, but now I like it and look forward to learning the techniques. Especially since we just started HVLA a couple weeks ago. Muscle energy gets boring after awhile

 

[Bacchus]

What about OMM lab???

Its kind of tongue in cheek with that comment. I don't go to lecture but they often talk about the science behind OMM which some in this thread are ignoring.

 

[Siggy]

Name one. Even if they're not fully tested with a double blind study, they're firmly rooted in known science and often have previous studies leading us to believe they'd work. For example, the flu vaccine.

Trendelenburg and prehospital spinal immobilization to name 2.

 

[NerdyAndrea]

People like to be touched in ways that feel good. I learned a lot about touch and palpation in Massage School. Perhaps just kind warm human touch does a lot for people, and they feel better from the attention.

I know that going in for physical medicine and being touched nicely and with care in a professional environment always makes me feel better.

Maybe that's a huge benefit of OMM?

I think touch makes everyone around us more human. If it's that making people feel better then perhaps the science behind something is human connection. Obviously not having studied the technique, I truly cannot say. I am not sure exactly what OMM entails, though I am sure I will understand later.

Andrea

 

[FutureCTDoc]

and to clarify, I was using the example of so many individuals using DCs to hint that although chiropractic may be a pseudoscience...many many people think their treatments work. And if you think a treatment works and your symptoms are relieved....thats as good as gold in my opinion.

Just because someone falls for the placebo effect doesn't make it right or appropriate to prescribe. Using sham treatments is inappropriate as a general course of action, save perhaps for malingering. The fact that some people believe that a DCs intervention will help doesn't lend any credence. Appealing to the masses is less than convincing. 61% of Americans don't believe in evolution http://www.gallup.com/poll/114544/darwin-birthday-believe-evolution.aspx does the fact that they don't believe in it make it any less true?