The thread was to talk about the value of articular manipulation, not rehash the md do debate that seems to go on ad nauseum. The net result of four years of medical school at either a do institution or md institution results in the ability to practice medicine in all fifty states of the union in any specialty. Getting into either type of institution is difficult, and surviving them tough. Both sets of boards are unpleasant, and yet both groups must suffer them to be deemed qualified to matricualte into thier respective 3rd and 4th years. We all suffer, whether osteopathic or allopathic a large degree of academic abuse and the lawyers and insurance executives still make too much.
Now onto the articular med and its efficacy. OTM, or your schools acronym (OMM, OMT, OPP) are better terms than articular med as you will soon be learning. Articulatory techniques are another treatment modality in the aresenal of manipulative med (OTM, OMM, OMT, OPP). Articular techniques themselves work on range of motion (ROM) of the joint that is being treated or the muscle that is being treated, and they can be a powerful tool. Other aspects of OTM are of course the ever popular "Kirksville crunch", counterstrain (a personal favorite), indirect techniques, muscle energy, cranial, high velocity low amplitude techniques, low velocity moderate amplitude, etc. There are a lot.
There have been a number of studies done showing that manual med does help to tx musculoskeletal problems effectively and with fewer drugs. Anecdotally there has been a lot reported concerning somatic-visceral responses and positive tx. However, that is the rub, they evidence is anecdotal and requires evidenced based research to truly prove its efficacy isn't merely placebo. D.O.'s bragging about their unproven tx is what cause the quack labels (Never mind trad. medicine is replete with examples of unproven treatments or treatments with pharmaceutics that work with some unknown mechanism).
Personally I think that OTM has the ability to be a powerful tool in the D.O.'s bag-of-tricks and should be used when it will benefit the patient. I plan to use it when I am in the real world and away from school, however, I think as Osteopaths we have a long row to hoe to prove the efficacy of some of our treatment modalities and move them beyond the realm of the anecdotal.
The new research center at TCOM is a great start and will hopefully fullfill some our research needs. In addition, here at KCOM, one of our clinicians was the first to recieve an NIH grant to study the efficacy of OTM in the tx of the elderly with pneumonia. His initial study showed that pts receiving trad. pharmacologic tx and otm were released from the hospital a day-and-a-half to two days earlier than those treated with pharmaceuticals alone. If this second study shows the same he will hopefully get funding for a multi-center study and this will at last prove, in a very narrow arena, what the profession has been arguing; that structure and function are interrelated and that properly alinging the structure will allow the patient to recover more quickly.
Anyway, the long and the short is I think it will help. Even if it doesn't prove to help, our pts perception is that we are invested in their health, and that is worth the extra time to tx someone if you aren't doing any harm.
Sweaty
