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    February 21, 2019 at 5:31 pm #2376
    1. WHEREAS, Osteopathic Manipulative Treatment (OMT) has been found to be as effective as
    2. standard therapy in treating low back pain1,2 and other chronic pain conditions, including migraine,
    3. temporomandibular disorders, cervical spine pain, and fibromyalgia,3,4,5,6,7 and
    4. WHEREAS, the use of OMT results in reduced pain medication usage by patients,1,3,4,8,9,10,11,12 and
    5. is associated with lower risk and lower cost,13 and “osteopathic treatment was found to be a
    6. dominant and cost-effective strategy compared to standard treatment,”14 and
    7. WHEREAS, OMT has been found to be effective in reducing chronic pain levels and improving
    8. functional status in chronic pain conditions such as migraine, temporomandibular disorders, cervical
    9. spine pain, fibromyalgia, and chronic prostatitis.24,25,26,27,31,32 OMT is also associated with reduced
    10. medication usage, including non-steroidal inflammatory and muscle relaxant consumption.
    11. WHEREAS, patients “generally [give] high ratings for satisfaction and were positive about the
    12. OMT following orthopedic and thoracic surgery,”15 and 63% of patients with back pain treated with
    13. OMT for 8 weeks reported an improvement in pain, while only 46% of the sham treatment group
    14. reported improvement,16 after which the authors concluded “a trial of OMT may be useful before
    15. progressing to other more costly or invasive interventions,” and
    16. WHEREAS, the Federation of State Medical Boards recommends the use of many therapies,
    17. including OMT, before, with, or in place of opioid therapies in order to minimize the inappropriate
    18. use thereof, and17, and the WHO recommends adjuvant therapies such as OMT at all steps of pain
    19. management, in the WHO “Pain Relief Ladder,” as pre-and co-therapy with opioid drugs,18 and
    20. WHEREAS, 66% of all drug overdose deaths involved opioids, and opioid overdose death rates
    21. increased 200% from 2000 to 2014; similarly, the number of deaths was five times higher in 2016
    22. than in 1999,19,20 and
    23. WHEREAS, opiate prescriptions cost $2.8 billion, while opiate misuse and abuse cost $78 billion in
    24. 2013,21 and dependence on opioids is associated with increased 30-day readmission rates after
    25. surgery, costing $41 billion per year in the US as of 2013, while inpatient stays resulting in opioid
    26. abuse have increased only 5% from 1993-2012,20
    27. WHEREAS, opiate prescription continues to increase, as they have since a 33% increase in
    28. dependence and addiction from 2002 to 2011;20 and one million patients were estimated to be
    29. dependent on prescribed opioids in 2006, with projected increases,23 and in 2013 National survey on
    30. Drug use and Health, 4.5 million individuals surveyed in one month in the US were current
    31. nonmedical users of prescription opioids22; now, therefore, be it
    32. WHEREAS, it is already well-established in the body of literature on OMT that prominent experts
    33. in the field believe OMT ought to be used preferentially in the treatment of chronic pain36,37,38,39,40
    34. RESOLVED, that the American Osteopathic Association recommend and reaffirm that Osteopathic
    35. manipulative treatment should be used as adjuvant therapy as part of a comprehensive pre-opioid
    36. non-cancer pain management plan. And be it further
    37. RESOLVED, that the Student Osteopathic Medical Association lobby the American Osteopathic
    38. Association’s Commission on Osteopathic College Accreditation form a task force to advance
    39. standards for OMT education in Colleges of Osteopathic Medicine, to standardize and optimize the
    40. future physicians’ education in treating chronic pain with OMT.

    Explanatory Statement
    The opioid addiction epidemic is continuing to grow out of control; it costs many lives and vital resources. Osteopathic manipulative treatments are a uniquely safe, affordable, efficient, and effective alternative which may reduce or remove the need for opioid drugs in non-cancer pain management, and should be used to alleviate this suffering.

     
    References

    1. Andersson et al, (1999). A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain. New England Journal of Medicine, 1999(341), 1426.-1431. doi:10.1056/NEJM199911043411903, Retrieved from https://www.nejm.org/doi/full/10.1056/nejm199911043411903
    2. Task Force on the Low Back Pain Clinical Practice Guidelines (2016). American Osteopathic Association Guidelines for Osteopathic Manipulative Treatment (OMT) for Patients With Low Back Pain. The Journal of the American Osteopathic Association, 2016, 116-536.
    3. Cerritelli F, et al. (2015). Clinical effectiveness of osteopathic treatment in chronic migraine: 3-Armed randomized controlled trial. Complement Ther Med, http://dx.doi.org/10.1016/j.ctim.2015.01.011
    4. Cuccia, A.M. et al. (2009). Osteopathic manual therapy versus conventional conservative therapy in the treatment of temporomandibular disorders: A randomized controlled trial. Journal of Bodywork and Movement Therapies, Volume 14, Issue 2, 179 – 184, https://doi.org/10.1016/j.jbmt.2009.08.002/
    5. Galindez-Ibarbengoetxea, X., Setuain, I., Ramírez-Velez, R., Andersen, L. L., González-Izal, M., Jauregi, A., & Izquierdo, M. (2018). Immediate effects of osteopathic treatment versus therapeutic exercise on patients with chronic cervical pain. Alternative Therapies in Health and Medicine, 24(3), 24-32.
    6. Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR. (2002). Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. The Journal of the American Osteopathic Association, 102:321-325.
    7. Schwerla F, Bischoff A, Nürnberger A, Genter P, Guillaume J, Resch K. (2008). Osteopathic Treatment of Patients with Chronic Non-Specific Neck Pain: A Randomised Controlled Trial of Efficacy. Forsch Komplementmed, 15:138-145. doi: 10.1159/000132397
    8. Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med. 2013;11(2):122-9.
    9. Licciardone JC. The OSTEOPATHIC Trial Demonstrates Significant Improvement in Patients With Chronic Low Back Pain as Manifested by Decreased Prescription Rescue Medication Use. J Am Osteopath Assoc 2014;114(7):528–529. doi: 10.7556/jaoa.2014.103.
    10. Pomykala M, McElhinney B, Beck BL, Carreiro JE. Patient Perception of Osteopathic Manipulative Treatment in a Hospitalized Setting: A Survey-Based Study. J Am Osteopath Assoc 2008;108(11):665–668.
    11. Prinsen JK, Hensel KL, Snow RJ. OMT Associated With Reduced Analgesic Prescribing and Fewer Missed Work Days in Patients With Low Back Pain: An Observational Study. J Am Osteopath Assoc 2014;114(2):90–98. doi:10.7556/jaoa.2014.022.
    12. Goldstein FJ, Jeck S, Nicholas AS, Berman MJ, Lerario M. Preoperative Intravenous Morphine Sulfate With Postoperative Osteopathic Manipulative Treatment Reduces Patient Analgesic Use After Total Abdominal Hysterectomy. J Am Osteopath Assoc 2005;105(6):273–279.
    13. Dubey, J. (2018). Osteopathic manipulative treatment for low back pain. Integrative Medicine Alert, 21(5) Retrieved from https://www.reliasmedia.com/articles/142604
    14. Verhaeghe, N., Schepers, J., Dun, P. V., & Annemans, L. (2018). Osteopathic care for low back pain and neck pain: A cost-utility analysis. Complementary Therapies in Medicine, Volume 40 (2018), 207-213. doi:10.1016/j.ctim.2018.06.001
    15. Sposato, et al. (2018). Osteopathic Manipulative Treatment in Surgical Care. Journal of Evidence-Based Integrative Medicine, 2. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5900809/
    16. Licciardone, J.C. (2016). Recovery From Chronic Low Back Pain After Osteopathic Manipulative Treatment: A Randomized Controlled Trial. Journal of the American Osteopathic Association, 116, 144.-155. doi:10.7556/jaoa.2016.031
    17. Gifford, J.D. et al (2017). Guidelines for the Chronic Use of Opioid Analgesics. Retrieved from https://www.fsmb.org/globalassets/advocacy/policies/opioid_guidelines_as_adopted_april-2017_final.pdf
    18. WHO’s Pain Relief Ladder. (2018). Retrieved from http://www.who.int/cancer/palliative/painladder/en/
    19. Dowell, D. (2016). CDC Guideline for Prescribing Opioids for Chronic Pain — United States. Morbidity and Mortality Weekly Report, 65(1), 1.-49. Retrieved from https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
    20. Gupta, A. et al. (2018). Opioid Abuse or Dependence Increases 30-day Readmission Rates after Major Operating Room Procedures: A National Readmissions Database Study. Anesthesiology, 128, 880.-890. doi:10.1097/ALN.0000000000002136
    21. Florence, C.S. et al (2013). The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States. Med Care, 54(10), 901.-906. doi:10.1097/MLR.0000000000000625.
    22. Mateu-Gelabert, P. (2015). Injection and sexual HIV/HCV risk behaviors associated with nonmedical use of prescription opioids among young adults in New York City. Journal of Substance Abuse Treatment, 48), 13.-20. doi:10.1016/j.jsat.2014.07.002
    23. Substance Abuse and Mental Health Services Administration. (2013). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD: Center for Behavioral Health Statistics and Quality
    24. Cerritelli F, et al. (2015). Clinical effectiveness of osteopathic treatment in chronic migraine: 3-Armed randomized controlled trial. Complement Ther Med, http://dx.doi.org/10.1016/j.ctim.2015.01.011
    25. Cuccia, A.M. et al. (2009). Osteopathic manual therapy versus conventional conservative therapy in the treatment of temporomandibular disorders: A randomized controlled trial. Journal of Bodywork and Movement Therapies, Volume 14, Issue 2, 179 – 184, https://doi.org/10.1016/j.jbmt.2009.08.002/
    26. Galindez-Ibarbengoetxea, X., Setuain, I., Ramírez-Velez, R., Andersen, L. L., González-Izal, M., Jauregi, A., & Izquierdo, M. (2018). Immediate effects of osteopathic treatment versus therapeutic exercise on patients with chronic cervical pain. Alternative Therapies in Health and Medicine, 24(3), 24-32.
    27. Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR. (2002). Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. The Journal of the American Osteopathic Association, 102:321-325.
    28. Andersson GB, Lucente T, Davis AM, Kappler RE, Lipton JA, Leurgans S. A comparison of osteopathic spinal manipulation with standard care for patients with low back pain. N Engl J Med. 1999; 341(19):1426–31. pmid:10547405
    29. Cerritelli F, Ginevri L, Messi G, Caprari E, Di Vincenzo M, Renzetti C, Cozzolino V, Barlafante G, Foschi N, Provinciali L. Clinical effectiveness of osteopathic treatment in chronic migraine: 3-Armed randomized controlled trial. Complement Ther Med. 2015 Apr;23(2):149-56. doi:10.1016/j.ctim.2015.01.011. Epub 2015 Jan 21. PMID: 25847552
    30. Cuccia AM, Caradonna C, Annunziata V, Caradonna D. Osteopathic manual therapy versus conventional conservative therapy in the treatment of temporomandibular disorders: a randomized controlled trial.J Bodyw Mov Ther. 2010 Apr;14(2):179-84. doi: 10.1016/j.jbmt.2009.08.002. Epub 2009 Sep 20. PMID: 20226365
    31. Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med. 2013;11(2):122-9.
    32. Licciardone JC. The OSTEOPATHIC Trial Demonstrates Significant Improvement in Patients With Chronic Low Back Pain as Manifested by Decreased Prescription Rescue Medication Use. J Am Osteopath Assoc 2014;114(7):528–529. doi: 10.7556/jaoa.2014.103.
    33. Pomykala M, McElhinney B, Beck BL, Carreiro JE. Patient Perception of Osteopathic Manipulative Treatment in a Hospitalized Setting: A Survey-Based Study. J Am Osteopath Assoc 2008;108(11):665–668.
    34. Prinsen JK, Hensel KL, Snow RJ. OMT Associated With Reduced Analgesic Prescribing and Fewer Missed Work Days in Patients With Low Back Pain: An Observational Study. J Am Osteopath Assoc 2014;114(2):90–98. doi:10.7556/jaoa.2014.022.
    35. Goldstein FJ, Jeck S, Nicholas AS, Berman MJ, Lerario M. Preoperative Intravenous Morphine Sulfate With Postoperative Osteopathic Manipulative Treatment Reduces Patient Analgesic Use After Total Abdominal Hysterectomy. J Am Osteopath Assoc 2005;105(6):273–279.
    36. Andersson GB, Lucente T, Davis AM, Kappler RE, Lipton JA, Leurgans S. A comparison of osteopathic spinal manipulation with standard care for patients with low back pain. N Engl J Med. 1999; 341(19):1426–31. pmid:10547405
    37. Cerritelli F, Ginevri L, Messi G, Caprari E, Di Vincenzo M, Renzetti C, Cozzolino V, Barlafante G, Foschi N, Provinciali L. Clinical effectiveness of osteopathic treatment in chronic migraine: 3-Armed randomized controlled trial. Complement Ther Med. 2015 Apr;23(2):149-56. doi:10.1016/j.ctim.2015.01.011. Epub 2015 Jan 21. PMID: 25847552
    38. Cuccia AM, Caradonna C, Annunziata V, Caradonna D. Osteopathic manual therapy versus conventional conservative therapy in the treatment of temporomandibular disorders: a randomized controlled trial.J Bodyw Mov Ther. 2010 Apr;14(2):179-84. doi: 10.1016/j.jbmt.2009.08.002. Epub 2009 Sep 20. PMID: 20226365
    39. Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med. 2013;11(2):122-9.
    40. Licciardone JC. The OSTEOPATHIC Trial Demonstrates Significant Improvement in Patients With Chronic Low Back Pain as Manifested by Decreased Prescription Rescue Medication Use. J Am Osteopath Assoc 2014;114(7):528–529. doi:10.7556/jaoa.2014.103.
    41. Pomykala M, McElhinney B, Beck BL, Carreiro JE. Patient Perception of Osteopathic Manipulative Treatment in a Hospitalized Setting: A Survey-Based Study. J Am Osteopath Assoc 2008;108(11):665–668.
    42. Prinsen JK, Hensel KL, Snow RJ. OMT Associated With Reduced Analgesic Prescribing and Fewer Missed Work Days in Patients With Low Back Pain: An Observational Study. J Am Osteopath Assoc 2014;114(2):90–98. doi:10.7556/jaoa.2014.022.
    43. Goldstein FJ, Jeck S, Nicholas AS, Berman MJ, Lerario M. Preoperative Intravenous Morphine Sulfate With Postoperative Osteopathic Manipulative Treatment Reduces Patient Analgesic Use After Total Abdominal Hysterectomy. J Am Osteopath Assoc 2005;105(6):273–279.

    Submitted by:
    Dakota A. Dalton, OMS II – Lincoln Memorial University – DeBusk College of Osteopathic Medicine
    Staci Hunter, OMS I – Lincoln Memorial University – DeBusk College of Osteopathic Medicine
    Megan Franzetti, OMS-II
    Skyler Hill-Norby, OMS II – Lincoln Memorial University – DeBusk College of Osteopathic Medicine
    Megan Franzetti, OMS II – New York Institute of Technology College of Osteopathic Medicine

    Action Taken:

    Date:
     
    Effective Time Period:
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