Letters to the Editor  |   July 2009
Survey Results: OMT and CAM
Author Affiliations
  • Danielle M. Lipoff, MS, OMS III
    Department of Neuroscience and Histology, New York College of Osteopathic Medicine of New York Institute of Technology, Old Westbury
Article Information
Osteopathic Manipulative Treatment
Letters to the Editor   |   July 2009
Survey Results: OMT and CAM
The Journal of the American Osteopathic Association, July 2009, Vol. 109, 346-347. doi:
The Journal of the American Osteopathic Association, July 2009, Vol. 109, 346-347. doi:
To the Editor:  
We would like to highlight a recent study by the National Center for Complementary and Alternative Medicine, a branch of the National Institutes of Health, containing important and relevant information for the osteopathic medical community, including osteopathic physicians, educators, and students. 
In the study, which is based on data collected in the Centers for Disease Control and Prevention's 2007 National Health Interview Survey (NHIS), Barnes et al1 identify a large number of metrics related to the use of complementary and alternative medicine (CAM), including osteopathic manipulative treatment (OMT), in the United States. 
A review of these data1 allow for greater understanding of the demographic characteristics of individuals who use CAM, as well as the types of CAM most likely to be used and the illnesses and conditions for which CAM is used. These data also allow for comparisons with 2002 data.2 Therefore, changes in CAM use in the United States between 2002 and 2007 can be analyzed. 
The 2007 NHIS data incorporated results of 23,393 completed interviews with adults aged 18 years or older.1 From a list of 36 types of CAM, 10 of which required the services of a practitioner (eg, acupuncturist, chiropractor, osteopathic physician, traditional healer), nearly 4 of 10 adult respondents (38.3%) reported using some form of CAM within the previous 12 months.1 
Among all CAM types, “chiropractic or osteopathic manipulation” ranked fourth in use by respondents; one or the other of these types of manipulation was used by 8.6% of surveyed adults during the previous 12 months.1 (Unfortunately, the survey results did not distinguish between chiropractic manipulation and OMT.) The use of chiropractic or osteopathic manipulation ranked behind that of “nonvitamin, nonmineral, natural products” (used by 17.7% of respondents), “deep breathing exercises” (used by 12.7% of respondents), and “meditation” (used by 9.4% of respondents).1 
These data suggest that OMT is among the most widely used types of CAM, though—surprisingly—not as widely used as some types of CAM that have questionable therapeutic value for such common conditions as neck, back, and joint pain. 
The reasons that the use of OMT ranks behind the other CAM types are not clear. We believe that these reasons may include lack of awareness, greater difficulty in accessing OMT, financial cost—or some combination of these factors. In light of the finding that almost 40% of surveyed adults reported using some form of CAM in 2007,1 these data indicate that greater public awareness of OMT is critically needed, as is greater ease of access to OMT. 
According to the 2007 NHIS survey,1 individuals with diverse conditions and illnesses—including anxiety, arthritis, diabetes mellitus, fibromyalgia, hypertension, and migraine headache—used CAM during the previous 12 months. The conditions and illnesses reported as most commonly affecting individuals who used CAM were “back pain or problems” (affecting 17.1% of respondents), “neck pain or problems” (affecting 5.9% of respondents), and “joint pain or stiffness or other joint conditions” (affecting 5.2% of respondents).1 Combining these conditions with “arthritis” and “other musculoskeletal conditions,” which were reported by 3.5% and 1.8%, of respondents,1 respectively, reveals that more than 30% of adults who used CAM in 2007 did so to manage musculoskeletal-related problems and pain. 
Thus, these results indicate that though more than 30 of 100 CAM users have musculoskeletal problems and pain, fewer than 9 of 100 CAM users seek OMT. This finding, in turn, suggests that individuals with musculoskeletal problems and pain constitute an important patient population for the osteopathic medical profession to target with greater dissemination of information regarding the therapeutic potential of OMT. 
We believe that other data contained in the 2007 survey results reported by Barnes et al1 would also be of interest to members of the osteopathic medical community. Such data include results related to CAM use by children; the age, race, and other demographic characteristics of CAM users; and changes in CAM use between 2002 and 2007. (In the 2002 NHIS survey,2 however, respondents were asked about their use of chiropractic manipulation but not about their use of osteopathic manipulation.) In addition, data on lifestyle and risk factors (eg, alcohol consumption, body weight, tobacco use) of individuals who use CAM are documented in both studies by Barnes et al,1,2 offering greater understanding of those seeking CAM care. 
An important and ongoing challenge for the osteopathic medical profession is the promotion of osteopathic medical philosophy, including its rich tradition and history as well as the science of OMT. How can progress in this important mission be evaluated and measured? One way is through the examination of empirical data on the use of CAM, such as that reported by Barnes et al.1,2 
Designing novel approaches for increasing public awareness of OMT will rely on further studies that use this modality in the greater context of CAM—including studies that distinguish between OMT and chiropractic manipulation. Increasing public awareness of OMT will also require increased monitoring of possible changes in the attitudes and healthcare needs of CAM users over time. 
We strongly believe that the osteopathic medical community must take an active role in, and perhaps be at the forefront of, this important area of study. 
Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. December 10, 2008:1-24. Available at: Accessed June 4, 2009.
Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. Adv Data. May 27, 2004:1-19. Available at: Accessed June 4, 2009.