The Journal of the American Osteopathic Association, 2004/08, 104(8):342. doi: 10.7556/jaoa.2004.104.8.337, type of study: ,ret,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2004.104.8.337/html)

Keywords:

low back pain [523]
OMT [3924]
osteopathic manipulative treatment [3945]
retrospective study [339]

Abstract:

Introduction/Hypothesis: Although Low Back Pain (LBP) rarely indicate serious disorder, it is a major cause of physician visits, disability and societal cost. The objective of this study was to assess the impact of OMT on the management of LBP. One could theorize that use of OMT would results in less medication prescription. Methods: We analyzed the 1997-2001 National Ambulatory Medical Care Surveys, which contain information on the utilization and provision of ambulatory care services in doctors' offices in the United States. The patients with LBP were identified by the main reason for the visit. We assessed if the patients were treated with OMT (categorized in the survey as physical modes of therapy, including OMT, performed by the practitioner) during the visit. Comparisons were made between the use and non-use of OMT for LBP according to management measures including diagnostic testing, imaging examination, number of medications prescribed, pain medications, surgical procedures, exercise counseling, admissions to hospital and time spent with patients. Multiple logistic regression modeing was used to determine the significant impact levels of OMT on those management outcomes. Results: During 1997-2001, there were about 21.4 million patient visits to DOs for LBP. Of those visits, 35.7% were treated with OMT. The DOs who performed OMT during the visits were less likely to order diagnostic tests and imaging studies than DOs who did not perform OMT. They also prescribed less drugs and pain medications, spent longer time with patients, and were more likely to provide exercise counseling. There were no significant differences in admissions to hospital and performing surgical procedures between the two groups of DOs. Conclusions: Based on the national data, use of OMT by DOs had some positive impact on the management of LBP in the setting of doctors' offices. Given the general under-utilization of OMT, greater efforts to promote OMT are urgently warranted, not only to improve patient care, but to retain our unique skills as a profession.