DO Difference

Pain patients on OMT: ‘I wish I had found you 30 years ago’

Osteopathic manipulative treatment offers distinct benefits for patients with pain, DOs say.


With their unique training in osteopathic manipulative medicine, DOs have an extra skill set to deploy when treating patients with pain. Three osteopathic physicians recently told The DO how they use osteopathic manipulative treatment (OMT) to relieve pain.

Pain diagnosis

Using palpation helps DOs to localize the source of pain. It can also help them determine whether medication is necessary and if so, how much, explains Brian F. Degenhardt, DO, the director of the A.T. Still Research Institute in Kirksville, Missouri. Palpation also allows the physician to evaluate whether patients’ reports of their pain are consistent with physical findings, which is useful when watching for signs a patient could be abusing opioids. “For patients, if somebody is willing to touch them and to begin to understand what their body feels like, especially when they’re in pain, they feel a greater call to be honest and truthful,” Dr. Degenhardt says, noting that OMT also fosters a closer doctor-patient bond.

[story-sidebar id=”184585″]

Treating a multifaceted condition

Pain management is a highly complex art form, says Mark Bailey, DO, PhD, a professor at the University of Alabama-Birmingham. For instance, a patient who sustained many broken bones after being hit by a truck 20 years ago might have arthritis in the affected areas, abnormal gait mechanics from limping and nerve-related pain.

Mark Bailey, DO, PhD

By the time such patients arrive at Dr. Bailey’s office, they’ve often seen many doctors already, so being able to offer a new treatment approach is valuable, he says. “It’s unlikely that there’s going to be a single magic pill, but if the patient has mechanical components to their pain, you can do something about it with your hands in the office,” he says.

Success stories

OMT often brings together the pieces of patients’ previous treatments for pain to create a more integrated recovery, says Brian Kaufman, DO, a pain medicine and osteopathic manipulative medicine specialist in Wells, Maine. A number of Dr. Kaufman’s patients who were on disability have been able to return to work after a year or two of multimodal treatment. Other patients, after receiving pain relief through OMT, have told Dr. Kaufman that they wish they had found him 20 or 30 years earlier. “OMT gets all the parts of the body to function in a coordinated fashion so everything works in harmony and synchrony, rather than the opposite,” he explains.


  1. Michael Kolinski DO

    I am board certified in NMM/OMM. I work in a pain management practice and I hear “I wish I had met you years ago” everyday by my patients. It’s very satisfying and rewarding to offer a modality that makes my patients more functional and less painful.

  2. Catherine Feaga

    I’m the only DO attending at our MD FP residency and practice full spectrum FM. I see an average of 4 patients per day for OMT in the office. It makes me happy to treat people, to use my hands, and to focus on deeper perceptions in our world. It gives me the mandate to slow down and be present. My patients appreciate that attention from me and I have found it also fosters deeper compassion. Patients then have a safe space where they can relax and release their pain even if just for 30-40min. We have a chance to talk too, about healthy eating, regular exercise, mindfulness – all of which can help chronic pain patients.

    Initially I was faced with many MDs who performed such a superficial MSK exam (if one at all), yet we all learned the same anatomy, so I like to remind them how to use what they have learned. I love that the residents now know how to diagnose and treat a tension headache and palpate even the basic muscle groups to aid in this and other diagnoses. I just wish all DOs used their hands to treat patients – the world would be a better place!

  3. B. Allyn Behling, DO

    I’m a part-time Palliative Medicine Fellow (working on building a palliative rehabilitation reputation) and a part-time private restorative physiatrist (PM&R) that regularly practices OMM…and it has made my life…as well as my patients’ lives infinitely happier! It seems to be a great way to balance attempts to optimize my patients’ quality of life despite their stage of life–from being able to participate in exercise again, to simply being able to sit with their family again at the dinner table.

    If I may make a few suggestions to the OMM-directed DO that has any sincere interest in regularly performing these procedures: 1) realize that you are are a rare find in the world of physicians (and patients will treasure you) 2) patients are desperate for someone to actually confirm what they already have a fair idea what is wrong with them….just because you bothered to observe, palpate and basically look for TART changes 3) learn how to bring these modalities not just to those suffering from pain, but also to those who need palliative care (and I don’t just mean hospice!), lastly 4) try to ensure that your care remains accessible (I may be private, but I still offer sliding scale and special payment plans).
    Best of luck, and keep your hands warm!

Leave a comment Please see our comment policy