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.
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.
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.
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.
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.