Applying osteopathic principles to formulate treatment for patients with chronic pain.

Osteopathic manipulative medicine (OMM) is a physician-directed approach to patient care that incorporates diagnostic and therapeutic strategies to address body unity issues, enhance homeostatic mechanisms, and maximize structure-function interrelationships. Osteopathic physicians integrate a thorough medical history with palpatory examination of a patient to ascertain distinctive characteristics and origins of the patient's pain, to evaluate how pain uniquely affects the patient, and to determine whether segmental, reflex, or triggered pain phenomena coexist in the patient. Osteopathic manipulative medicine expands differential diagnoses by allowing the physician to consider somatic dysfunction and implement treatment options via integration of specific aspects of complementary care into state-of-the-art pain management practices. Prescriptions formulated through an OMM algorithm integrate each osteopathic tenet with biopsychosocial and patient education models, as well as manual medicine, pharmacologic, and rehabilitation techniques proportionate to individual needs. This "refreshed" version of an article originally published in September 2005 includes the addition of an anecdotal case scenario in which application of osteopathic principles and practice created a personalized, effective treatment plan for the described patient's chronic pain.