OMT for Pilots

OMT: The military pilot’s drug-free treatment option

Learn how OMT is putting pilots who would otherwise be unable to fly back to work.


Last August, underneath a canopy on a beach in Key West, Florida, soldiers lined up behind Lt. Col. Natalie Nevins, DO, to receive osteopathic manipulative treatment (OMT) on their first day off in over two weeks.

Across the world, Capt. Matthew Puderbaugh, DO, was on a mission in Poland where he, too, watched airmen form a line to receive manipulation on an OMT table he’d made from two crates stacked alongside each other.

Dr. Nevins and Dr. Puderbaugh use OMT to non-pharmacologically treat back pain, muscle spasms, and other conditions in military pilots. Receiving OMT often keeps pilots off of drugs that they can’t legally take while flying. OMT is putting pilots who would otherwise be unable to fly back to work.

Health concerns for military pilots

Spending long hours seated in the small cockpit of a military aircraft to complete high-stress missions is mentally and physically trying. Narcotics and muscle relaxants relieve physical pain, but military pilots can’t take them on the job. Enter OMT.

“OMT helps to keep pilots in the air because muscle relaxers or narcotics are grounding medications,” says Dr. Puderbaugh, a flight surgeon with the 37th airlift squadron at the Ramstein Air Base in Germany.

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Osteopathic flight surgeons not only keep military pilots flying, but also recognize when they shouldn’t be in the air, says Dr. Nevins.

“Pilots know flight surgeons can ground them from flying, so they don’t always want to be forthright about areas that are bothering them,” says Dr. Nevins. “I have a great relationship with my pilots because they know I can do something about what’s going on without making them incapable of flying.”

Common conditions

Dr. Puderbaugh frequently uses OMT to treat upper respiratory infections, cervicalgia and headache disorders.

“I performed cranial manipulation on a patient who had severe post-traumatic headaches,” says Dr. Puderbaugh. “Within two sessions, the patient had reduced her narcotic medications and was back to working a full-duty day.”

Dr. Puderbaugh also swears by OMT as a diagnostic tool.

“I might not always have access to advanced imagining, so using OMT and my palpatory skills have been beneficial in deciding whether or not a patient needs an aeromedical evacuation,” he says.

OMT in demand

Both Dr. Nevins and Dr. Puderbaugh say their OMT skills are in high demand, and that the treatment is widely recognized within the military as instrumental for pilots and other service members.

“When the military finds out you’re a DO who does manipulation, it spreads like wildfire,” says Dr. Nevins, who figures she’s saved the military around $250,000 in physical therapy referrals over six months.

Dr. Puderbaugh agrees.

“Once people learn you can do OMT, it can open up the floodgates quite a bit,” he says.


  1. James Aston, DO

    While I was active duty in the USAF, OMT was a hot commodity. Our clinic was fortunate to have anywhere from 3-5 DOs at any given time who were all actively using OMT in their practice. Near the end of my service, I was actually doing only OMT in the clinic, treating pilots, controllers, AD members, retirees and families. I often wondered why the military doesn’t actively pursue setting up OMT clinics, because the nature of military job requirements leads to musculoskeletal pain…

  2. Charles Hooper, D.O.

    I spent 18 years in the United States Navy and had the opportunity to work in various Navy Hospitals. I was happy to see many D.O.’s practicing in the Military and many used OMT as a modality. The Patients appreciated it.

  3. D. E. Lovins, DO MPH CAPT MC USN SWMDO (Ret)

    My MPH thesis in 1992 demonstrated that Army helo pilots would seek chiropractic care outside of the military. I provided care to numerous aviators in my career. Glad to see the times have improved.

  4. Matthew S. Reeves, DO, MBA

    I can echo many of the sentiments above. It was much easier getting my pilots to accept OMT than to take a Tylenol post flight for their aches and pains. And much more effective as we were treating the cause and not masking symptoms! I had the honor to care for Marine pilots out of MCAS Cherry Point 2d MAW

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