The AAO Journal, 2012/12, 22(4):38-45, type of study: ,rct,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

chronic pain [324]
opiod pain medication [2]
narcotic pain medication [1]
osteopathic manipulative treatment [3946]
OMT [3925]
randomized controlled trial [947]
pilot study [216]

Abstract:

Context: Osteopathic Manipulative Medicine (OMM) has been shown to be an effective non-pharmacological treatment of pain. Opiate narcotics are shown to be amongst the most effective pharmacologic methods for pain relief, despite their addictive properties. However, there is lack of research that addresses opioid use, chronic pain and the benefits of OMM concurrently. Objectives: To develop a protocol to effectively evaluate the benefits of OMM to relieve symptoms of chronic pain enough to allow for the dose of narcotic pain medications to be reduced and/or discontinued entirely. Methods: This is a randomized, prospective, controlled pilot study, with an intention to treat protocol. Subjects were 21 to 55 years old experiencing pain for at least three months, and were referred by their primary care physician. All patients had four weekly visits the first month, followed by two visits the second month and one the third month. All subjects received osteopathic structural exams at each visit. Patients in the treatment group received OMM at each visit, while patients in the placebo control group did not receive OMM. Patients completed a pain and disability questionnaire (PDQ) at the beginning and completion of the study, and a pain diary and pill counts at each visit. Results: Three patients were referred, two patients were enrolled and one patient participated. The protocol is reproducible, the forms used are adequate and the data is analyzable. Subject 2’s pain level as recorded from the pain diary decreased from 8/10 to 7/10, with resolution of midback pain, though low-back pain remained. The subject’s pill count remained steady throughout the study, averaging four pills/day. Conclusions: Our experience supports the feasibility of conducting this study on a larger scale. The protocol is reproducible, and the outcome measures and forms for data collection are effective for evaluation and subsequent data analysis. Subject recruitment, enrollment and retention are difficult. A larger patient population, more referring physicians and an assistant available for sameday enrollment and scheduling are needed to increase the subject pool.