# Current Use and Effects of Osteopathic Manipulative Treatment (OMT) in the Military: A Scoping Review

## TL;DR

This paper reviews how osteopathic manipulative treatment (OMT) is used in the US military to treat musculoskeletal pain and improve functionality.

## Contribution

This is the first scoping review to evaluate the use and effects of OMT specifically within military populations.

## Key findings

- OMT is effective in reducing pain and improving functionality in military personnel.
- OMT is associated with reduced opioid use and lower healthcare costs.
- OMT is comparable to nonsteroidal anti-inflammatory drugs in pain relief.

## Abstract

Osteopathic manipulative treatment (OMT) is a hands-on therapy approach used by osteopathic physicians that aims to alleviate viscero-somatic changes by considering the interconnectedness of the body, mind, and spirit. One of the most common uses for OMT is the treatment of musculoskeletal (MSK) complaints, which are a significant cause of pain and disability across various populations, including the US Military, where personnel often face unique and physically demanding working conditions. In 2019, MSK injuries alone accounted for nearly half of the limited duty days in the US Army, with low back pain being the leading cause of medical encounters over the past 10 years among active-duty personnel. Previous studies have shown that OMT can improve functional status, reduce pain, and have minimal adverse effects when treating low back pain. It has also been found to be twice as effective as placebo treatments and comparable to nonsteroidal anti-inflammatory drugs in terms of pain relief. Given the high incidence rates of MSK issues during active duty in the military, OMT may be a viable treatment or adjunctive therapy option for this population. The purpose of this scoping review is to evaluate the current research on OMT among US military members and veterans, determining any potential positive or negative effects that may be attributed to this therapy. A comprehensive search was conducted across six databases from inception to November 2023, yielding 497 articles, which were screened according to inclusion and exclusion criteria. Nine studies were ultimately included and evaluated based on the target treatment area. The most commonly employed forms of OMT included myofascial release, soft tissue manipulation, and counterstrain techniques. The primary outcomes after OMT were reduced pain and improved range of motion or functionality. Other positive findings included a decrease in opioid usage, reduced nausea, lower healthcare costs, and lower incidence of alcohol and substance use disorders within the military populations studied. This is the first review of its kind to evaluate OMT within military populations, demonstrating its effectiveness in reducing pain, increasing functionality, and lowering complications associated with military duties. Further research into the utilization of OMT within the military should be pursued, considering it as a potential first-line or adjunctive therapy for service members and veterans across various settings and dysfunctions to continue evaluating its long-term effectiveness.