Clinicians and researchers at the Michigan State University College of Osteopathic Medicine have concluded that the osteopathic manipulative therapy (OMT) is a highly effective treatment to decrease the amount of disability and pain experienced by patients suffering from constant neck discomfort. Nonspecific chronic pain as opposed to acute pain which is defined as lasting more than three months in which no pathoanatomical root can be determined.
Jacek Cholewicki, who is a professor of spinal biomechanics in the Department of Osteopathic Manipulative Medicine and an active part of the Center for Neuromusculoskeletal Clinical Research The reason he decided to carry out this study because of the dearth of research that focuses on this topic. The majority of people suffer from an acutely painful experience at some point throughout their lives.
“A lesser percentage will experience an ongoing pain condition,” Cholewicki said. Although it’s a tiny percent, it’s an enormous health issue that is affecting many millions.”
Somewhat surprisingly, Cholewicki and his team found the treatment also improved patients’ sleep quality, fatigue and depression–conditions that “seem to go hand-in-hand with chronic pain in general,” he noted.
Nonspecific, chronic back and neck pains are complex problems that have multiple contributing causes. “There is no magic solution however, typically an approach that is multimodal is advised,” he said.
One common misconception for chronic pain sufferers is that their pain is either an organic root cause, something that is visible on an MRI for instance, or it’s all in their heads.
“I believe it’s important to make it clear that all pain is in your head. It has to relate to sensory nerves and the way that the brain interprets this,” Cholewicki told the BBC. “Chronic pain can cause modifications in the nerve system. Patients may become hypersensitive to stimuli or the brain may be misinterpreting feedback. The pain doesn’t necessarily mean it isn’t actual, but if the changes in the nervous system can cause it to persist, treatment could require psychological and physical components.”
While studies have shown that the use of single treatments, such as OMT and physical therapy provide clinically significant positive effects on patient outcomes It is difficult to determine which patients will benefit from the same treatment or one. Cholewicki suggests the most efficient first step in treatment is to mix several treatments, including exercise and movement rather than bed rest one of the primary aspect in the prevention of chronic pain.
Cholewicki says that the osteopathic approach’s whole-of-life approach to care provides the ideal research framework that can be used to study treating chronic pain. The findings of his study that OMT could have a positive effect on fatigue, sleep and depression have prompted Cholewicki to further study the role of psychosocial factors in chronic pain, for example, how beneficial it is to have human contact as well as the doctor-patient relationship, or the expectation of patients that treatment will work.
He counsels doctors and medical students to help the patient. “Self-efficacy is the best indicator of effective treatments,” stated Cholewicki. “Educate patients on the treatment options available to them–for instance, exercise doesn’t necessarily make the condition worse, and they are able to take control of their own situation.”
The study is published online in PM&R: The Journal of Injury, Function and Rehabilitation.