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Osteopathic Manipulative Medicine as a Possible Adjunct Therapy for Chronic Pain Management in an Era of Opioid Misuse and Abuse: A Clin-IQ (1)

Zrenda K, Foster A, Fugate C
Oklahoma State University Medical Center, Tulsa, OK, United states

Abstract: Chronic pain management is a discussion area in the medical field with concerns regarding the misuse and abuse of opioid medications. In America, opioid overdose deaths have quadrupled between 1999 and 2015 (2). Overprescribing and childhood exposure have also increased with one in every five adolescents misusing opioids and high percentages of adolescents receiving opioid prescriptions prior to first-line agent use for a specific complaint (3,4). Studies have also shown discordance in opioid use reporting among adolescents (5). Osteopathic manipulative medicine (OMM) for the management of chronic pain has been evaluated over the years with evidence suggesting it as an efficacious adjunct therapy that may reduce the rising statistics of the opioid epidemic (6,7,8). Studies have shown no statistical significance between OMM and standard therapies alone (6); however, have shown statistical significance in the reduction of chronic back pain with use of OMM versus sham treatments, with substantial improvement in those reporting high baseline pain severity (7,8). Studies have also shown statistical significance in the reduction of prescription analgesics with use of adjunct OMM (7,8). Further high-quality studies are needed to assess the efficacy and longevity of management with OMM for chronic pain as well as its role in decreasing the use, misuse, and abuse of opioid analgesics.
Keywords: osteopathic manipulative medicine, chronic pain, opioid abuse, adolescents
REFERENCES:
1. Welborn, MD, MPH., McCarthy, MLIS. Clin-IQ Preparation Toolkit. Osctr.ouhsc.edu. 2014. Available at: http://osctr.ouhsc.edu/sites/default/files/Clin-IQ%20Toolkit%20%207-21-14.pdf. Accessed December 28, 2017.
2. Center for Disease Control and Prevention (Ed.). (2017, August 30). Understanding the Epidemic. Retrieved December 28, 2017, from https://www.cdc.gov/drugoverdose/epidemic/
index.html
3. DeVries A, et al. Opioid Use Among Adolescent Patients Treated for Headache. Journal of Adolescent Health. 2014;55(1):128-133. doi:10.1016/j.jadohealth.2013.12.014.
4. Vosburg S, et al. Prescription Opioid Abuse, Prescription Opioid Addiction, and Heroin Abuse Among Adolescents in a Recovery High School: A Pilot Study. J Child Adolesc Subst Abuse. 2015;25(2):105-112. doi:10.1080/1067828x.2014.918005.
5. Palamar J, et al. Discordant reporting of nonmedical opioid use in a nationally representative sample of US high school seniors. Am J Drug Alcohol Abuse. 2016;42(5):530-538. doi:10.1080/00952990.2016.1178269.
6. Andersson, G. B., MD, PhD et al (1999). A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain. The New England Journal of Medicine, 341(19), 1426-1431. doi:10.1056/NEJM199911043411903
7. Licciardone J, Kearns C, Minotti D. Outcomes of osteopathic manual treatment for chronic low back pain according to baseline pain severity: Results from the OSTEOPATHIC Trial. Man Ther. 2013;18(6):533-540. doi:10.1016/j.math.2013.05.006.
8. Licciardone J, Minotti D, et al. Osteopathic Manual Treatment and Ultrasound Therapy for Chronic Low Back Pain: A Randomized Controlled Trial. The Annals of Family Medicine. 2013;11(2):122-129. doi:10.1370/afm.1468.


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