NMM/OMTORIGINAL ARTICLE

Osteopathic manipulative treatment among long-term opioid prescribed patients

Brian K. Yorkgitis, DO; Ira Harmon, MS; Azad Khan, MBBS; Fern Webb, PhD; and Gabriel Brat, MD, MPH
Notes and Affiliations
Notes and Affiliations

Received: December 27, 2024

Accepted: April 29, 2026

Published: June 11, 2026

  • Brian K. Yorkgitis, DO, 

    Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA

  • Ira Harmon, MS, 

    Center for Data Solutions, University of Florida College of Medicine, Jacksonville, FL, USA

  • Azad Khan, MBBS, 

    Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA

  • Fern Webb, PhD, 

    Department of Surgery, University of Florida College of Medicine, Jacksonville, FL, USA

  • Gabriel Brat, MD, MPH, 

    Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA

Abstract

Context: Nonpharmacologic treatments are recommended for the treatment of pain including osteopathic manipulative treatment (OMT). It has been shown there is low utilization of OMT and disparities in access in patient with pain conditions.

Objectives: The objective of this study is to describe the current landscape of OMT receipt as an adjunct in adult patients prescribed opioids. Through the exploration of a national outpatient database, this study will discern if there are disparities to receiving OMT.

Methods: Through a deidentified, national health record database, patients with seven categories of pain-provoking conditions who receive ≥3 opioid prescriptions were queried for receipt of OMT. Demographics, pain conditions, prescribed opioid morphine milliequivalent dose, and insurance data were analyzed.

Results: Of 98,892 patients meeting the inclusion criteria, 1,371 (1.4 %) received OMT. Patients under 60 years, female, White race, and having multiple pain-provoking conditions were more likely to receive OMT. Medicaid was the most common payer type for those who received OMT. Hispanic and Black patients received less OMT than non-Hispanic White patients.

Conclusions: Despite recommendations for nonpharmacologic therapies to treat pain, OMT use remains low among patients on long-term opioid therapy for pain-provoking conditions. In this study, there were racial and ethnic differences with White patients receiving OMT more often than others. Further work is needed to assure access to OMT as part of a patient’s pain treatment plan across all populations.

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