Osteopathic manipulation treatment 'very effective' for post-COVID-19 symptoms

Osteopathic manipulation treatment may be an effective treatment option for alleviating post-COVID symptoms, according to a speaker at the American Osteopathic Association’s OMED conference.

Osteopathic manipulation treatment, or OMT, is typically used to relieve pain, improve circulation or “correct structural imbalances in your body,” according to the Cleveland Clinic. Other research presented at OMED suggested that it also may help reduce burnout in health care workers.

Violeta B. Foss, OMS-III, and Jashandeep Kaur, OMS-III, both third-year osteopathic medical students at the New York Institute of Technology College of Osteopathic Medicine (NYITCOM), as well as their colleagues, sought to “explore the utility and effectiveness of OMT in post-COVID patients, focusing on the approaches and target areas most frequently used,” Foss said. Their goal was to potentially create OMT protocols by common symptoms to help “guide post-COVID management in the future,” she added.

“Osteopathic physicians may be the key to closing the gap where traditional approaches to managing those symptoms fall short,” Foss said. “While studies on the topic are still limited, osteopathic manipulative treatment, or OMT, may be a powerful tool in optimizing multiresistant post-COVID symptom management and improving our patients’ overall functional capacity.”

Foss cited data from the CDC demonstrating the prevalence of post-COVID symptoms. Three months following a positive COVID-19 test, 31.6% of patients reported head, ear, nose and throat symptoms, 25.4% reported constitutional symptoms, 16.8% had musculoskeletal symptoms and 14.7% had pulmonary symptoms.

“What’s interesting is that regardless of acute COVID severity, and even in mild cases, many patients continue to experience chronic post-COVID symptoms, which are resistant to current available treatments. Those symptoms encompass multiple body systems and include lingering fatigue and nausea and abdominal pain,” Foss said.

To better understand OMT’s impact on patients’ chronic post-COVID symptoms, Kaur said the researchers sent a REDcap survey link to NYITCOM department of osteopathic manipulative medicine faculty and adjunct faculty. They included both quantitative and qualitative questions, collecting information on experiences treating patients with post COVID-19 symptoms in specific organ systems, including the gastrointestinal, musculoskeletal, pulmonary cardiovascular systems and more.

The 18 osteopathic physicians who responded to the survey also answered questions regarding OMT modality, body regions treated, number of manipulation sessions and perceived efficacy.

Of the 18 physicians, 78.6% had 15 or more years in practice post-residency and 85.7% of their field practice was neuromusculoskeletal medicine and osteopathic manipulative medicine. About 78% said they saw patients with post-COVID symptoms and provided OMT accordingly.

Most of their patients, the physicians reported, were aged 30 to 75 years and had been experiencing symptoms for more than 7 days prior to treatment — many, though, had been dealing with symptoms for a month or more.

In all, the physicians reported encountering 51 clinical presentations. The most common patient symptoms reported by providers were:

• pulmonary, including dyspnea and cough;
• musculoskeletal, including muscle fatigue and pain;
• neurological, including headache, anosmia and sleep disturbance;
• cardiovascular, including palpitations and chest wall pain;
• gastrointestinal, including diarrhea, acid reflux, nausea and abdominal pain;
• genitourinary, including dysuria and pelvic pain; and
• other, including otorhinolaryngological, rheumatological and psychobehavioral symptoms.

“The majority of reported patient presentations were in pulmonary, musculoskeletal and neurological systems,” Kaur said. “Predominantly, the complaints were dyspnea cough, muscle fatigue, muscle pain, headache and nausea and perceived disturbance.”

To address these symptoms, the physicians utilized a variety of techniques, the most common of which were balanced ligamentous tension, cranial OMT and lymphatics.

“Likely due to their broader applicability, indirect modalities, such as balanced ligamentous tension and cranial OMT, were more frequently utilized by NYITCOM and adjunct faculty compared to techniques that included a direct component, such as muscle energy technique and still technique,” Foss said.

Overall, OMT in these cases was deemed “extremely effective” by 35.3% of providers, “very effective” by 43.1% of providers and “somewhat effective” by 15.7% of providers, Kaur said. None of the providers rated OMT as not effective at all, or even just slightly effective, she said.

“Although self-reported, the overall effectiveness across various organ systems seems promising,” Foss said.

Foss also said there is a “need to raise awareness of the role of OMT in post-COVID management, which may improve patient outcomes even further.”

“Ultimately, guided by the principles of anatomy and physiology, osteopathic physicians can help create OMT management protocols in order to alleviate a variety of persistent post-COVID symptoms, which are resistant to existing pharmacological treatments,” Foss said. “The goal is to improve patient quality of life in a multitude of ways and fulfill our mission as osteopathic physicians.”

References:

• COVID data tracker. https://covid.cdc.gov/covid-data-tracker/#inspire. Accessed Nov. 11, 2022.
• Osteopathic manipulation treatment (OMT). https://my.clevelandclinic.org/health/treatments/9095-omt-osteopathic-manipulation-treatment. Accessed Nov. 11, 2022.
• Foss V, et al. Impact of osteopathic manipulative medicine (OMM) & osteopathic manipulative treatment (OMT). Presented at: OMED22; Oct. 27-31, 2022; Boston.