Letters to the Editor  |   June 2006
Author Affiliations
    JAOA—The Journal of the American Osteopathic Association Chicago, Ill Clinical Professor Michigan State University College of Osteopathic Medicine East Lansing, Mich
    Associate Editor
  • Michael A. Seffinger, DO
    Western University of Health Sciences College of Osteopathic Medicine of the Pacific Pomona, Calif
    Assistant Professor
Article Information
Medical Education / Neuromusculoskeletal Disorders / Osteopathic Manipulative Treatment / Pain Management/Palliative Care / Being a DO / Low Back Pain / OMT in the Laboratory
Letters to the Editor   |   June 2006
The Journal of the American Osteopathic Association, June 2006, Vol. 106, 317-318. doi:
The Journal of the American Osteopathic Association, June 2006, Vol. 106, 317-318. doi:
Osteopathic medical student Greg P. Hansen highlights several important ideas in his letter commenting on “The Somatic Connection,” the new section in JAOA—The Journal of the American Osteopathic Association that reviews research on the musculoskeletal system recently published in other peer reviewed journals (J Am Osteopath Assoc. 2006; 106:118–119). It is also important to point out that although the majority of research studies on manipulation are conducted by “osteopaths” in other countries or by chiropractors or physical therapists, such studies can still have relevance for osteopathic physicians in the United States. 
“The Somatic Connection” is intended to provide readers with information on research related to the tenets and principles of osteopathic medicine, especially manipulative techniques used to influence the musculoskeletal system. A number of future summaries in “The Somatic Connection” will highlight recent discoveries about the biological mechanisms underlying the efficacy of various musculoskeletal interventions, thereby helping to clarify the role of the musculoskeletal system in health and disease. Although many of these studies will be from nonosteopathic researchers and institutions, their findings have relevance for the application of osteopathic tenets and principles in patient care. 
Mr Hansen expresses concern about the inclusion in “The Somatic Connection” of a systematic review by Bronfort et al1 that combined chiropractic and osteopathic manipulation studies. He asks whether this inclusion constitutes an endorsement by the JAOA of chiropractic manipulation. A systematic review of the efficacy of spinal manipulative techniques for individuals with low back pain entails assessing the scientific rigor of all studies retrievable by literature searches—regardless of the training of the professionals who performed the manipulation. Of course, the most rigorous studies are given more credence in determining the answer to the question of efficacy. Featuring a review of this type in “The Somatic Connection” should not be misconstrued as an endorsement by the JAOA of chiropractic manipulation. Rather, the systematic review by Bronfort et al1 was featured because of its inclusion of clinical trials in which osteopathic manipulative treatment (OMT) was performed by osteopathic physicians. Thus, the Bronfort et al1 review provides osteopathic medical researchers with an objective assessment of the level of scientific rigor of their endeavors. 
Mr Hansen suggests that future editions of “The Somatic Connection” systematically review osteopathic studies in an objective and scientific manner. However, it is not the intent of “The Somatic Connection” to systematically review research. Instead, “The Somatic Connection” presents summaries of studies related to the tenets and principles of osteopathic medicine that were reported in other, mostly nonosteopathic, medical and scientific journals. Many of these studies were not conducted by osteopathic medical researchers or osteopathic medical institutions. Nevertheless, they may provide information applicable to osteopathic medical practice. 
The field of neuromusculoskeletal medicine is vast. Thus, it is necessary to combine the cumulative knowledge from various perspectives to determine the best possible care for our patients. As the editors of “The Somatic Connection,” we welcome comment and dialogue as we continue to introduce the readers of the JAOA to this rapidly growing body of literature from around the world. 
 Editor's note: The next edition of “The Somatic Connection” will appear in the July 2006 issue of JAOA—The Journal of the American Osteopathic Association.
Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis [review]. Spine J. 2004;4:335 –356.