I recently requested to volunteer as a physician at a race. I was told that I could volunteer as a physician but that I could not provide osteopathic manipulative medicine (OMM) because the tents were not equipped for ‘major manipulations’ and that doing so is contraindicated on the athletes because they mostly have musculoskeletal issues and exhaustion. There are so many parts of this statement that shows ignorance about OMM, what it is, and how to use it. Somehow I do not believe that the same physician above would tell a specialist surgeon, whose specialty of which they have little knowledge, when their special procedures are indicated and contraindicated. Doing so would be offensive to the specialist. Unfortunately, this misunderstanding among physicians and the general public is very common. I would like to take this opportunity to address this issue.
Physicians are often reluctant to refer patients because they are ignorant of OMM and fear that all I will do is inappropriately use a thrusting technique that could do more damage than good. I understand physicians assume that I will “pop” and aggressively treat all people that come through my door including frail or osteoporotic patients. Many doctors will overlook the fact that I have had full medical training; medical school, internship, and residency to understand indications and contraindications of all the techniques I use. They feel that the safer alternative is to prescribe medications or refer the patient to an orthopedist or perhaps a pain specialist. Those who have read some of my previous posts or come to me as patients know that I do not even use any thrusting techniques. Regardless, injuries from rapid thrusting techniques are rare and much safer than prescription medications.
Some argue that there is not enough evidence showing the validity that OMM or hands-on therapies work, but that there is plenty of evidence that medications work. Perhaps this is true but lets look at the evidence from a different perspective. Addiction to prescription painkillers is rampant in our society. The USA Today and many other sources have written articles about this and it largely goes ignored. According to the Centers for Disease Control and Prevention, “prescription drugs cause most of the more than 26,000 fatal overdoses each year.” In addition, overdose deaths from opioid painkillers has tripled in the last 10 years. Prescription painkiller overdoses have surpassed overdoses from heroin and cocaine. Overdoses from prescription medications have become a “largely unrecognized epidemic.” In his book, Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Health Care, Peter Gotzsche points out that prescription related deaths are now 3rd behind heart disease and cancer.
So looking at the bigger picture, I have found very little evidence that people are dying at alarming rates from all hands-on therapies. This includes thrusting therapies from chiropractors, osteopathic physicians, physical therapists and other manual practitioners. Is there a risk going to a manual therapist? Absolutely, but it is minimal. There’s always a risk with anything you do, but remember that prescription medications are not necessarily a safer alternative, especially when looking for pain relief.
Patients who come to me for OMM receive a individualized hands-on treatment that is gentle, does not involve rapid thrusting, and overall is very safe. Secondly, I work on musculoskeletal issues on a daily basis, and I understand the anatomical and physiological basis of what I am trying to achieve. This understanding, in addition to complete medical training, make me well aware of what techniques are indicated and contraindicated in patients. My aim, just like any other physician, is to improve overall health of my patients in the safest way possible. Sometimes the OMM is meant to work synergistically with to enhance the medications a patient is taking and not replace medications.
My hope is that someday the medical community will be open enough that they would welcome and see what a valuable asset an osteopathic manipulative medicine specialist could be in treating not just athletes at races and patients who deal with pain. OMM is very safe for dealing with pain but your doctor may disagree being unaware of the harm the prescription pain medications may be causing or ignoring their potential dangers anyway. What about you? Do you believe anatomy plays a role in health or do you believe the body is a bag of biochemicals that needs the right medication to be healthy? The pharmaceutical industry hopes you believe in the latter.