Treating Acute musculoskeletal neck pain with Osteopathic Manipulative Treatment

Source: http://www.jaoa.org/cgi/content/full/105/2/57

JAOA • Vol 105 • No 2 • February 2005 • 57-68

Intramuscular Ketorolac Versus Osteopathic Manipulative Treatment in the Management of Acute Neck Pain in the Emergency Department: A Randomized Clinical Trial

Tamara M. McReynolds, DO; Barry J. Sheridan, DO

Acute musculoskeletal neck pain is a common complaint among the general population in the United States and is a frequent problem for patients presenting to the emergency department (ED). Up to 71% percent of Americans can recall experiencing an episode of neck pain or stiffness in their lifetimes.

In the ED, providing pain relief for patients with neck pain is the primary goal—after any significant pathology or injury has been excluded from diagnostic evaluation. Patients are commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs). Osteopathic manipulative treatment (OMT) is another treatment modality that may be considered, however. Manipulation of the cervical spine for neck pain (and headache) is the second most common use of spinal manipulative therapy.
Osteopathic manipulative treatment is based on osteopathic principles and practice. Fundamental to the science and art of osteopathic medicine is the recognition of the body's inherent ability to restore homeostasis and heal itself. Various osteopathic manipulative (OM) techniques are applied in regions of somatic dysfunction (ie, areas of impaired or altered function of the body framework) to promote blood flow through the tissues, thus enhancing the body's own healing ability.

Terminology used to describe manual therapies varies. Osteopathic physicians use the term manipulation to describe over 100 different OM techniques.In the literature, many researchers use the term manipulation to describe high velocity, low amplitude (HVLA) thrust techniques. A thrust is a force applied to the joint that moves it beyond the passive range of motion and often produces an audible click at the joint.Mobilization is a nonthrust form of manipulation that applies a manual force to the spinal joints within the passive range of motion.

The term manipulation in our study describes manipulative therapies as used by chiropractors, physiotherapists, other "manual therapists," and osteopathic physicians—as when we inquired of study subjects prior to study enrollment if they had ever received "prior manipulation." The term osteopathic manipulative treatment (ie, OMT), however, is used in our study only when osteopathic physicians in the treatment of patients use OM techniques. In this study, the OM techniques used by osteopathic physicians include HVLA thrust, soft tissue, and muscle energy techniques.

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