wow!

[Bookworm]

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So I?ve been looking at OstMed, and I was looking for research into chronic low back pain and efficacy of OMM. The only article I really found was :

Andersson GBJ , Lucente T , Davis AM , Kappler RE , Lipton JA , and Leurgans S
A comparison of osteopathic spinal manipulation with standard care for patients with low back pain [see comments]
From the New England Journal Of Medicine in 1999.

This was a good study and it showed that OMM was effective in lowering med for sub chronic back pain, but my question is this: Is it really the case that this is the only research project that?s been done for chronic low back pain and OMT? That kind of shocks me.

 

[Castro Viejo]

Uhm, actually the article you're referring to is the first to be published in a major journal like NEJM.

Though I haven't done the research myself, I'm sure if you were to look into JAOA you'll find a lot more stuff on this topic. The quality of studies published in JAOA ranges from not-so-good to okay.

If I remember correctly the NEJM article you refer to found no significant difference between the efficacy of OMT versus standard care (NSAIDs, PT, etc.) for chronic LBP, and that the one advantage for using OMT over pharmacotherapy was the avoidance of the drugs themselves.

Is there also a journal of the American Academy of Osteopathy?

 

[Bookworm]

yea, i know it's in the new england journal of med.

i think your interpretation of the results is correct -- i think it's pretty significant that OMM is AS effective as medication.

The reason I was surprised was that I expected that many other studies that, although perhaps were not as scientific had at least been attempted. What surprised me was that I didn't find many of these other studies that you also expected to find.

I looked on Ostmed. Maybe I wasn't just entering the right search terms? I would have thought that someone else at least attempted to research on low back pain and OMM before this study.

 

[PublicHealth]

Osteopathic physicians need to conduct more research on OMM and publish results in good journals in order to prove the efficacy of OMM relative to conventional therapies. The DO[/I] had a feature issue on this, which suggested that osteopathic research programs will be gaining productivity in the years ahead.

If only 0.1% of graduating DOs (AACOM annual report) choose to pursue OMM residencies each year, it will be difficult for osteopathic medicine to attract students into becoming "traditional osteopaths." Be that as it may, many DOs use OMM in their practices in other areas such as neurology, some with promising results (word of mouth). Thus, at least case reports and some published articles (e.g., Andersson et al., 1999) suggest that OMM is indeed effective. Long-term studies are needed to determine the effectiveness of OMM for a range of medical conditions compared to other therapies.

The NIH recently established a National Center for Complementary and Alternative Medicine that funds research in this area (http://nccam.nih.gov/). It's high time that osteopathic physicians who believe in OMM start hypothesizing and testing.

PH

 

[PublicHealth]

The ball starts rolling...

http://nccam.nih.gov/clinicaltrials/osteopathicmanipulation.htm

 

[drusso]

I'm attending a research conference this weekend specifically geared to OMM research. Click on this website and down load the conference program to read the abstracts of newest OMM research presented at the conference.

http://www.aacom.org/calendar/events/occtic/

 

[Plinko]

The 1999 article from the NEJM served its purpose in that it broached a topic severely underserved by leading medical publications, but I do not agree that it was at all correct in its findings that OMT was equal to standard treatment methods. The authors admit this much several times over. If you look at the article again, you will see that there are problems with its procedure. For example, that there was no blinding of the patients, which in a study that is based exclusively on the subjective perception of pain by it's subjects, can have major consequences as to its outcome. Second, there was no controal group. This leads one to believe that there was no way to gauge how patients inflicted with CLBP might improve with no treatment at all. It is possible that the patients selected might have improved without being treated by either of the two treatment modalities. Thirdly, OMM is an art as much as it is a science, and a doc's personal preferences are of extreme importance when it comes to the outcome of the patient's final condition. The study's OMM procedure included only three doctors from Midwestern, two of which due to scheduling problems could not participate all that much in the study. This left most of the OMM workload to just one DO. That is hardly an adequate sampling of the various approaches to OMT by DOs across the county. I would take that article with a grain of salt, and simply view it as an appropriate first step in trying to attract more attention to the comparison between OMT and standardized treatment methods for CLBP.