Osteopathic Manipulative Treatment (OMT) is more than just an alternative approach—it is a vital component of a comprehensive pain management plan. This hands-on osteopathic care allows providers to address persistent pain by promoting healing at the source.
“Every patient can benefit from OMT at one time or another, but patients with persistent pain disorders get particular benefits,” said Marla D. Golden, DO, MS, FACEP, dean of the Doctor of Osteopathic Medicine program at PCOM South Georgia.
Persistent pain disorders may originate from underlying structural issues within the body or develop as a result of injury. Regardless of the cause, determining an appropriate osteopathic treatment plan requires a thorough structural musculoskeletal evaluation.
“Any alteration of normal structure—and the way people move, stand, or sit as a response to it—alters the ease of functional movement and puts abnormal stressors on other parts of the body,” Golden explained.
When this happens, patients experience pain not only at the site or the injury or structural problem but also in other areas. OMT, Golden added, can help relieve pain by easing muscle spasms, reducing inflammation, improving circulation, enhancing tissue oxygenation and addressing structural stressors.
“Working on the body has far reaching effects all the way to the nervous system—and the other organ so involved in the persistent pain process—the brain,” Golden said. “It’s a way to flood the brain with a soothing stimulus of great magnitude since it can be done in and on all areas of the body.”
By interrupting the pain processing loop between the brain and body, OMT can work to slow down or even eliminate the pain cycle. According to Golden, this is why OMT should be a mainstay of patient care.
Chronic pain is a complex disease process. Instead of relying upon opioids and interventional procedures, Golden advocates starting with simpler, non-invasive modalities like OMT.
Medications, she explained, can become a “too easy” solution—a quick fix that often leads to dependency, particularly with opioid pain relievers and anti-anxiety medications.
“Chronic use of opioids has been found to create a separately identifiable pain state,” she said. “They also adversely alter sleep patterns, the gastrointestinal system (gut and intestines) and the heart. Patients' pain thresholds go down such that they cannot tolerate even the slightest pain. It becomes a vicious cycle.”
For prospective medical students considering a future in osteopathic medicine, the shift in pain management philosophy highlights the growing relevance of the profession’s foundational skills.
OMT provides direct access to fascia, the connective tissue system that plays a central role in pain signaling, inflammation, and healing. Fascia acts as a communication network between body and brain. Through techniques like myofascial release, strain-counterstrain, and high-velocity low-amplitude adjustments, osteopathic physicians can treat pain at its source—without relying on medications or invasive procedures.
“OMT can alleviate so much of the pain associated with musculoskeletal disorders that it often takes care of a patient's problem without any other intervention,” Golden said. “If this is the case, the patient doesn’t have to undergo unnecessary tests and treatments.”
For medical students entering the field, this translates into practical advantages. Incorporating OMT as part of comprehensive medical care improves patient outcomes and fosters a deeper physician-patient connection.
“Every patient can benefit from OMT at one time or another, but patients with persistent pain disorders get particular benefits."
Marla D. Golden, DO, MS, FACEP
Golden emphasized that clinical environments that support OMT, along with workshops and continuing education, are essential for skill development. As healthcare continues to shift toward integrative, patient-centered models, the demand for physicians who can offer hands-on healing is expected to grow.
“[Osteopathic pain management] is a comprehensive approach to the patient, their complaints, their lifestyle, their occupation, their hobbies and habits of life, their injuries and their unique anatomical structure,” Golden said.
By addressing these interconnected factors, this approach works to optimize the patient’s structure, enabling them to function more effectively in daily life. As Golden emphasized, “The goals of any pain care program should be to decrease pain, increase functionality, and overall quality of life!”
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