The AAO Journal, 2025/06, 35(2):10–11. doi: 10.53702/i2375-5717-35.2.5, type of study: ,obs,

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p5.xml)

Keywords:

children [321]
observational study [246]
opioids [44]
OMT [3925]
osteopathic manipulative treatment [3946]
pediatrics [573]
sickle cell disease [4]

Abstract:

Background: Children with sickle cell disease (SCD) suffer from acute SCD pain that confers substantial morbidity. Non-pharmacologic therapies are needed, as pharmacologic pain control is often inadequate. Osteopathic manipulative treatment (OMT) is a novel, potentially valuable adjunct therapy. Hypothesis: OMT will decrease pain and opioid use in children with acute SCD pain. Research Design: Prospective, single- institution, observational study evaluating patients with SCD aged 3-26 years hospitalized with acute SCD pain. IRB approval was obtained. Interim analysis included data obtained April 2024-November 2024. Methods: Patients received standard-of-care pharmacologic management and were offered OMT. Informed consent was obtained. OMT was provided by a board-certified osteopathic physician. Safety was assessed by adverse event grading. Feasibility was defined as completion of OMT without interruption to standard care. Pain and constipation were assessed with validated FACES and Bristol stool scales, respectively. Oral morphine milligram equivalents (MME), laxative doses, and bowel movements within 24 hours of OMT were collected. Data were reported with descriptive statistics. Results: Seven patients were screened and received OMT. Majority were female (n=5, 71%) with median age 16 years (range 10-19 years). All OMT encounters were completed without care interruption. No adverse events occurred within 24 hours of OMT. After OMT, all FACES scores were decreased (n=4, 57%) or unchanged (n=3, 43%). Oral MME decreased in most cases (n=6, 86%), with median decrease of 29%. Bristol stool scores indicated unchanged or softer stools in most cases (n=6, 86%). Three patients had bowel movements within 24 hours of OMT. Conclusion: At interim analysis, OMT is feasible with no attributable adverse events. In this small sample, OMT resulted in decreased pain, opioid requirements, and constipation. Findings support continued investigation of OMT integration into SCD pain management.