Herb & supplement monograph

Osteopathic Manipulation Drug Interactions, Uses, Effectiveness, Safety & More

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Interaction report

Drugs that interact with Osteopathic Manipulation

0 medications have a known interaction with Osteopathic Manipulation, graded by severity. Select any drug for the full evidence-based detail.

We don’t currently list any known drug interactions for Osteopathic Manipulation. This doesn’t guarantee none exist — always confirm with your pharmacist before combining supplements with your medications.

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Osteopathic Manipulation combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
Monograph

Osteopathic Manipulation: Uses, Safety & Side Effects

The bottom line

Osteopathic manipulative treatment (OMT) is a hands-on therapy used mainly for musculoskeletal pain such as low back pain. The best evidence supports modest, short-term relief for some types of pain, while benefits for non-musculoskeletal conditions are not well proven. It is generally low-risk when done by a trained provider, but you should discuss it with your doctor first.

Part used
Not applicable (a hands-on manual therapy, not a plant or supplement)
Common forms
Hands-on treatment performed by a trained osteopathic physician (DO) or other qualified provider
People commonly use it for
  • Low back pain
  • Neck pain
  • Tension headaches
  • Muscle and joint stiffness
  • General musculoskeletal discomfort

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Generally low-risk when performed by a trained provider, but not appropriate for everyone.

PregnancyPossibly Safe

When osteopathic manipulation is administered appropriately by a trained professional, short-term. Some research shows that osteopathic manipulation g...

Read the full pregnancy detail
BreastfeedingPossibly Safe

When osteopathic manipulation is administered appropriately by a trained professional, short-term. Some research shows that osteopathic manipulation g...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Osteopathic manipulation, often called osteopathic manipulative treatment (OMT), is a hands-on therapy used by osteopathic physicians (DOs) and some other trained providers. It is not a pill, herb, or supplement. Instead, the provider uses their hands to move, stretch, and apply gentle pressure to your muscles, joints, and connective tissue.

OMT grew out of osteopathic medicine, a healthcare approach developed in the United States in the late 1800s. The idea is that the body's structure (bones, muscles, and tissues) and its ability to function are closely linked. Practitioners use OMT to try to ease pain, improve movement, and support the body's own healing.

People most often seek OMT for muscle and joint problems, especially back and neck pain. A typical session involves a physical exam followed by hands-on techniques chosen for your specific complaint.

How it works

The proposed idea behind OMT is that gentle hands-on techniques can help restore normal movement and alignment, relax tight muscles, improve blood and lymph flow, and reduce pain signals. Practitioners use a variety of methods, including soft-tissue stretching, joint mobilization, and gentle positioning techniques.

Some research suggests manual therapies may affect how the nervous system processes pain and may help reduce muscle tension. However, the exact reasons OMT helps some people are not fully understood, and many of the proposed mechanisms have not been firmly proven.

Effectiveness

Does Osteopathic Manipulation work?

Evidence overview · 32 uses evaluated
3 Possibly effective 1 Leans ineffective 28 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.
Possibly Effective Back pain
Rating & evidence shown verbatim from Natural Medicines

Most research shows that osteopathic manipulation improves low back pain. Meta-analyses of 10 studies show that osteopathic manipulation moderately reduces pain and improves function in patients with non-specific chronic low back pain when compared with a sham or active control. However, the quality of most evidence is low, and more evidence is needed to determine whether some types of osteopathic manipulation is more beneficial than others. Also, studies are heterogeneous with respect to the frequency, number, and duration of osteopathic sessions, as well as the treatment period.

Possibly Effective Neck pain
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research shows that osteopathic manipulation improves neck pain and disability. This benefit has been shown in clinical trials and pragmatic clinical trials. Most studies have used 3-5 sessions of treatment, usually in comparison with baseline or a waitlist or usual care control group. However, five times weekly has also been used. Most studies have included patients with chronic neck pain; however, other studies have included patients with subacute neck pain or neck pain due to whiplash injury. Some research also shows that osteopathic manipulation is beneficial for improving sleep, feelings of depression, and range of motion in patients with chronic neck pain. Further well-designed clinical trials are needed to confirm these findings and to investigate the potential for long-term benefits.

Possibly Effective Pregnancy-related pain
Rating & evidence shown verbatim from Natural Medicines

Meta-analyses of preliminary clinical research evaluating pregnant adults and those in the postpartum period show that osteopathic manipulation moderately reduces back pain and improves function when compared with a control.

Sources Ref 98758
Possibly Ineffective Cerebral palsy
Rating & evidence shown verbatim from Natural Medicines

A clinical study in children aged 5-12 years with cerebral palsy shows that receiving six cranial osteopathic manipulation sessions over 6 months does not improve motor function, sleep, pain, or quality of life when compared with a waitlist control.

Sources Ref 98766
Also studied for 28 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Asthma
Rating & evidence shown verbatim from Natural Medicines

A low-quality clinical study in children with asthma shows that osteopathic manipulation, including rib raising, muscle energy for ribs, and myofascial release, might improve peak flow rates when compared with a sham therapeutic touch control. However, other preliminary clinical research in children with asthma given standard care shows that a single osteopathic manipulation, including rib raising and suboccipital release, does not improve spirometry values over standard care alone.

Insufficient Reliable Evidence To Rate Athletic performance
Rating & evidence shown verbatim from Natural Medicines

The evidence related to the use of osteopathic manipulation for athletic performance is mixed and of low quality, with some research showing no beneficial effect. One small preliminary clinical trial in male athletes shows that a 30-minute osteopathic manipulation prior to testing does not improve a 30-second anaerobic performance when compared with sham treatment. Manipulation involved diaphragm and veno-lymphatic drainage techniques.

Sources Ref 109300
Insufficient Reliable Evidence To Rate Attention deficit-hyperactivity disorder (ADHD)
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in children with ADHD shows that receiving six 40-minute osteopathic manipulations in addition to conventional care seems to modestly improve speed, but not accuracy, on visio-spatial attention tests when compared with conventional care alone.

Sources Ref 104060
Insufficient Reliable Evidence To Rate Autism spectrum disorder
Rating & evidence shown verbatim from Natural Medicines

A small longitudinal observational study in children with autism spectrum disorder has found that receiving visceral osteopathic technique for 30 minutes weekly for 6 weeks is associated with modestly improved behavior and communication when compared to baseline. The validity of these findings is limited by the lack of a comparator group.

Sources Ref 104062
Insufficient Reliable Evidence To Rate Carpal tunnel syndrome
Rating & evidence shown verbatim from Natural Medicines

A small, low-quality study in patients with carpal tunnel syndrome shows that receiving osteopathic manipulation once weekly for 6 weeks seems to improve symptoms and function when compared with control.

Sources Ref 104063
Insufficient Reliable Evidence To Rate Chronic obstructive pulmonary disease (COPD)
Rating & evidence shown verbatim from Natural Medicines

Research on osteopathic manipulation in COPD is limited to small, low-quality studies yielding conflicting results. A small clinical study in patients 65 years and older with COPD shows that osteopathic manipulation might worsen airway obstruction 30 minutes after treatment when compared to sham treatment. However, this worsening has not been noted in other small studies. One small clinical study in patients 63 years and older with COPD shows that receiving one session of osteopathic manipulative therapy is no better than sham therapy for improving lung function, hyperinflation, or dyspnea. Another small clinical study in patients with an average age of 71 years with moderate to severe COPD shows that receiving weekly osteopathic manipulation sessions for 6 weeks in addition to standard therapy improves dyspnea and walking when compared with baseline. The validity of this study was limited by the lack of statistical comparison to the control group.

Insufficient Reliable Evidence To Rate Colic
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in infants with colic shows that administering cranial osteopathic manipulation once weekly for 4 weeks might reduce crying and improve the time spent sleeping when compared with no treatment.

Sources Ref 88704
Insufficient Reliable Evidence To Rate Coronary artery bypass graft (CABG) surgery
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients undergoing CABG surgery shows that post-surgical osteopathic manipulation seems to improve cardiac function, venous oxygen saturation, thoracic impedance, and cardiac index when compared with no treatment. There is also interest in using osteopathic manipulation to improve recovery after CABG. A small study in patients undergoing CABG shows that receiving osteopathic manipulation seems to improve functional recovery and reduce time to discharge by a non-significant amount when compared with receiving usual care alone. This study might not have been adequately powered to detect smaller differences between groups.

Insufficient Reliable Evidence To Rate Crohn disease
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients with quiescent Crohn disease shows that receiving three 60-minute sessions of osteopathic manipulation every 15 days, in addition to standard therapy, improves quality of life and reduces fatigue, irritable bowel syndrome (IBS)-like symptoms, and use of antispasmodics when compared with receiving standard therapy alone. Another small clinical study in patients with Crohn disease shows that receiving three sessions of softer osteopathic manipulative techniques over 30 days seems to improve quality of life and physical function, but not pain, when compared with baseline. The validity of this study was limited by lack of statistical comparison to the control group.

Insufficient Reliable Evidence To Rate Cystic fibrosis
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients with cystic fibrosis receiving standard therapy shows that osteopathic manipulation treatments for 15 minutes daily for 4-7 days does not improve spirometric measures, but might improve patient perception of breathing quality, when compared with sham osteopathic manipulation. Osteopathic manipulation has also been assessed for reducing pain in this population. A small clinical study in patients with cystic fibrosis shows that osteopathic manipulation does not reduce pain when compared with sham treatment or no treatment. This study might not have been adequately powered to detect smaller differences between groups.

Insufficient Reliable Evidence To Rate Depression
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in premenopausal adults with depression shows that osteopathic manipulation, in conjunction with paroxetine and psychotherapy, might be more beneficial for treating depression than paroxetine and psychotherapy alone.

Sources Ref 88702
Insufficient Reliable Evidence To Rate Fibromyalgia
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in female patients with fibromyalgia shows that osteopathic manipulation with standard care might reduce pain and improve subjective disability and discomfort when compared with standard care alone. However, a large clinical trial shows that six sessions of osteopathic manipulation over 6 weeks is no more effective than sham manipulation for reducing pain and fatigue and improving functioning over a 12-month period.

Insufficient Reliable Evidence To Rate Generalized anxiety disorder (GAD)
Rating & evidence shown verbatim from Natural Medicines

A small, low-quality clinical study in patients with moderate to severe GAD shows that receiving 5 individualized osteopathic manipulation treatments over 9 weeks seems to improve scores on the Hamilton Anxiety Scale (HAM-A) and the Intolerance for Uncertainty Scale, but not the Beck Anxiety Inventory, when compared to baseline. The validity of these findings is limited by the lack of a control group.

Sources Ref 104066
Insufficient Reliable Evidence To Rate Irritable bowel syndrome (IBS)
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients with refractory IBS shows that receiving visceral osteopathic manipulation of the gastrointestinal organs for 45 minutes at three different sessions over 2 weeks improves diarrhea, abdominal distension, and abdominal pain, but not constipation, when compared with sham treatment. Another small clinical study in patients with IBS shows that receiving osteopathic manipulation on days 1 and 8 reduces IBS symptom severity by at least 25% when compared with sham osteopathic treatment.

Insufficient Reliable Evidence To Rate Knee pain
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in runners with patellofemoral pain shows that six sessions of osteopathic manipulation, involving joint manipulation and myofascial release in the lower region of the body, modestly reduces pain and improves function when compared with receiving no treatment. However, osteopathic manipulation was no more effective than an exercise program for the lower limbs.

Sources Ref 109289
Insufficient Reliable Evidence To Rate Nipple fissures
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in term infants who had suboptimal breastfeeding behaviors due to either nipple fissures or maternal pain shows that two sessions of osteopathic manipulation within the first 11 days of life does not increase the breastfeeding rate at one month when compared to a sham control group in which osteopathic manipulation was performed on a doll behind a screen.

Sources Ref 109296
Insufficient Reliable Evidence To Rate Pneumonia
Rating & evidence shown verbatim from Natural Medicines

Evidence for the use of osteopathic manipulation in hospitalized elderly patients with pneumonia is conflicting. Small pilot studies in patients 60 years and older who were hospitalized for acute pneumonia showed mixed results on duration of hospital stay and antibiotic use when patients received either regular care or osteopathic manipulation for 10-15 minutes twice daily for up to 7 days. A large multi-centered study in patients 50 years or older who were hospitalized with pneumonia shows that adding osteopathic manipulation for 15 minutes twice daily until discharge to usual care does not reduce the length of hospital stay, time to clinical stability, or time to recovery when compared with usual care alone or usual care with light touch, in an intention-to-treat analysis. Subgroup analyses of this trial found possible benefit in patients 75 years of age and older, but not in any other subgroups. Patients in this age group receiving osteopathic manipulation or light touch had a hospital mortality rate of 2% and 3%, respectively, compared with 13% in the usual care group (13%).

Insufficient Reliable Evidence To Rate Postoperative pain
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients undergoing total abdominal hysterectomy shows that preoperative intravenous morphine 10 mg, combined with three post-surgical osteopathic manipulation sessions, does not improve pain, nausea, or vomiting, but might reduce postoperative morphine requirements, when compared with sham manipulation and preoperative intravenous morphine 10 mg.

Sources Ref 88711
Insufficient Reliable Evidence To Rate Postoperative recovery
Rating & evidence shown verbatim from Natural Medicines

The evidence for the use of osteopathic manipulative treatment for postoperative recovery outcomes is conflicting. Preliminary clinical research in patients post-cardiac surgery shows that receiving 5 days of osteopathic manipulation therapy in addition to standard rehabilitation therapy decreases length of hospital stay by about 2 days and reduces pain when compared to standard rehabilitation alone. Osteopathic manipulation has also been evaluated in patients post-joint replacement. Other preliminary clinical research shows that post-operative osteopathic manipulative treatment might improve ambulation, decrease analgesic requirements, and decrease length of hospital stay in patients undergoing elective knee or hip arthroplasty. However, additional preliminary clinical research shows that osteopathic manipulative treatment does not improve rehabilitation or decrease length of hospital stay in patients that had received a knee or hip arthroplasty due to osteoarthritis or hip fracture. The difference in these outcomes might be related to the clinical status of the patient prior to undergoing arthroplasty.

Insufficient Reliable Evidence To Rate Prematurity
Rating & evidence shown verbatim from Natural Medicines

A meta-analysis of five preliminary clinical trials shows that osteopathic manipulative treatment reduces the length of hospital stay by about 3 days on average in preterm infants when compared with a control. The magnitude of effect seems to depend on the degree of prematurity. In infants born before 32 weeks' gestation, hospital stay was reduced by 9 days. In infants born between 32-34 weeks' gestation or 34-36 weeks' gestation, the length of hospital stay was reduced by 3 days and 2 days, respectively.

Sources Ref 98759
Insufficient Reliable Evidence To Rate Sleep apnea
Rating & evidence shown verbatim from Natural Medicines

A small clinical trial in patients with sleep apnea shows that osteopathic manipulation of the sphenopalatine ganglia does not reduce symptom severity when compared with sham manipulation. However, peak nasal inspiratory flow is modestly increased. Although effort was made to blind both the patient and the physician involved in testing of clinical endpoints to treatment group, the osteopath needed to be aware of group allocation. This may have resulted in some bias.

Sources Ref 109298
Insufficient Reliable Evidence To Rate Spinal cord injury
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients with spinal cord injury shows that receiving seven 45-minute osteopathic manipulative treatments over 3 months with pharmacotherapy seems to reduce both neuropathic and nociceptive pain when compared with receiving either osteopathic manipulation alone or pharmacotherapy alone.

Sources Ref 104061
Insufficient Reliable Evidence To Rate Sprains
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients with acute ankle injuries shows that osteopathic manipulation along with conventional therapy improves pain and swelling, but not range of motion, immediately after treatment, when compared with conventional therapy alone.

Sources Ref 88715
Insufficient Reliable Evidence To Rate Temporomandibular disorders (TMD)
Rating & evidence shown verbatim from Natural Medicines

A small clinical trial in patients with TMD shows that receiving gentle 15-25 minute osteopathic manipulation sessions over 6 months results in lower use of rescue analgesic medications, but does not further improve pain or mouth opening, when compared with conventional conservative therapy. Another small clinical trial in female patients with TMD shows that receiving five 30-minute osteopathic manipulation treatments within a week seems to be no different for improving pain when compared with receiving manipulative treatments referred to as osteopathy in the cranial field.

Insufficient Reliable Evidence To Rate Tendinopathy
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research shows that osteopathic manipulative treatment for eight weeks may be as effective as orthopedic treatment for improving pain and strength in patients with a type of tendinopathy known as chronic lateral epicondylitis (tennis elbow).

Sources Ref 88716
Insufficient Reliable Evidence To Rate Tension headache
Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research in patients with episodic tension-type headache shows that receiving osteopathic manipulation therapy once weekly for 4 weeks reduces headache frequency by 33% when compared with sham therapy. Osteopathic manipulative treatment has also been evaluated in conjunction with progressive muscular relaxation (PMR) exercises. Preliminary clinical research in patients with tension-type headaches shows that adding 3 osteopathic manipulative treatments to PMR exercises increases the number of headache-free days per week when compared with PMR alone.

Insufficient Reliable Evidence To Rate Tonsillitis
Rating & evidence shown verbatim from Natural Medicines

Clinical research in patients with tonsillitis shows that a single osteopathic manipulation using a high-speed, low-amplitude technique at the T9-T10 vertebrae reduces the time to resolve tonsillitis by about 0.4 days when compared with sham manipulation. However, a sub-analysis shows that this benefit was only significant in adults. The number of episodes per year after treatment was reduced by approximately 1.2 in adults and children combined, with 61% of patients in the treatment group having no recurrence, compared with 39% of those given sham treatment. Patients and evaluators were blinded for this study.

Sources Ref 109297
Insufficient Reliable Evidence To Rate Vertigo
Rating & evidence shown verbatim from Natural Medicines

A small clinical study in patients with benign-paroxysmal-positional vertigo (BPPV) shows that receiving three 20-minute osteopathic manipulative treatments over one week seems to improve dizziness and function as measured on the Dizziness Handicap Inventory (DHI) when compared with sham manipulation.

Sources Ref 104072

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

When performed by a trained, licensed provider, OMT is generally considered low-risk, especially the gentle techniques. However, it is not right for everyone. People with osteoporosis, bone fractures, certain joint or spine conditions, cancer involving the bones, infections, blood-clotting problems, or severe disc disease should be cautious and may need to avoid certain techniques.

High-velocity techniques (quick thrusts), especially on the neck, carry rare but more serious risks and should only be done after careful evaluation. Always tell your provider about all your health conditions before treatment.

Pregnancy: Gentle OMT is sometimes used to ease back and pelvic discomfort during pregnancy, but it should only be done by a provider experienced in treating pregnant patients. Breastfeeding: There is no known risk to nursing from manual therapy. When in doubt, check with your doctor or pharmacist first.

Side effects

The most common side effects are mild and short-lived, such as soreness, stiffness, tiredness, or temporary increases in pain in the treated area. These usually go away within a day or two.

Serious side effects are rare. They are more likely with forceful, high-velocity techniques, particularly involving the neck. Seek medical care right away if you have severe pain, weakness, numbness, dizziness, vision changes, or trouble speaking after treatment.

Osteopathic Manipulation: Reported Adverse Effects

Documented safety reports on Osteopathic Manipulation from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Reports by condition
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no standardized "dose" for OMT. The number and frequency of sessions depend on your condition, your response, and your provider's judgment. Some people feel better after one or a few visits, while others need ongoing care.

Because OMT is a hands-on medical treatment rather than a product, the best approach is to discuss a treatment plan directly with a licensed osteopathic physician or qualified provider. Ask how many sessions they recommend and when you should expect to see improvement.

Pregnancy & Breastfeeding

Osteopathic Manipulation & Pregnancy

Possibly Safe

When osteopathic manipulation is administered appropriately by a trained professional, short-term. Some research shows that osteopathic manipulation given for 20 minutes seven times during the third trimester of pregnancy is safe with regard to labor and delivery outcomes.

  1. Hensel KL, Roane BM, Chaphekar AV, Smith-Barbaro P. PROMOTE Study: Safety of Osteopathic Manipulative Treatment During the Third Trimester by Labor and Delivery Outcomes. J Am Osteopath Assoc. 2016;116(11):698-703.

Osteopathic Manipulation & Breastfeeding

Possibly Safe

When osteopathic manipulation is administered appropriately by a trained professional, short-term. Some research shows that osteopathic manipulation given for 20 minutes seven times during the third trimester of pregnancy is safe with regard to labor and delivery outcomes.

  1. Hensel KL, Roane BM, Chaphekar AV, Smith-Barbaro P. PROMOTE Study: Safety of Osteopathic Manipulative Treatment During the Third Trimester by Labor and Delivery Outcomes. J Am Osteopath Assoc. 2016;116(11):698-703.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 52 references that drive our Osteopathic Manipulation monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Guiney PA, Chou R, Vianna A, Lovenheim J. Effects of osteopathic manipulative treatment on pediatric patients with asthma: a randomized controlled trial. J Am Osteopath Assoc 2005;105(1):7-12.
  2. Plotkin BJ, Rodos JJ, Kappler R, et al. Adjunctive osteopathic manipulative treatment in women with depression: a pilot study. J Am Osteopath Assoc 2001;101(9):517-23.
  3. Gamber RG, Shores JH, Russo DP, et al. Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. J Am Osteopath Assoc 2002;102(6):321-5.
  4. Hayden C, Mullinger B. A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic. Complement Ther Clin Pract 2006;12(2):83-90. PubMed
  5. Williams NH, Wilkinson C, Russell I, et al. Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care. Fam Pract 2003;20(6):662-9. PubMed
  6. Noll DR, Shores JH, Gamber RG, et al. Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia. J Am Osteopath Assoc 2000;100(12):776-82.
  7. Noll DR, Shores J, Bryman PN, Masterson EV. Adjunctive osteopathic manipulative treatment in the elderly hospitalized with pneumonia: a pilot study. J Am Osteopath Assoc 1999;99(3):143-6, 151-2. PubMed
  8. Goldstein FJ, Jeck S, Nicholas AS, et al. Preoperative intravenous morphine sulfate with postoperative osteopathic manipulative treatment reduces patient analgesic use after total abdominal hysterectomy. J Am Osteopath Assoc 2005;105(6):273-9.
  9. Yurvati AH, Carnes MS, Clearfield MB, et al. Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery. J Am Osteopath Assoc 2005;105(10):475-81.
  10. Jarski RW, Loniewski EG, Williams J, et al. The effectiveness of osteopathic manipulative treatment as complementary therapy following surgery: a prospective, match-controlled outcome study. Altern Ther Health Med 2000;6(5):77-81.
  11. Licciardone JC, Stoll ST, Cardarelli KM, et al. A randomized controlled trial of osteopathic manipulative treatment following knee or hip arthroplasty. J Am Osteopath Assoc 2004;104(5):193-202.
  12. Eisenhart AW, Gaeta TJ, Yens DP. Osteopathic manipulative treatment in the emergency department for patients with acute ankle injuries. J Am Osteopath Assoc 2003;103(9):417-21.
  13. Geldschlager S. [Osteopathic versus orthopedic treatments for chronic epicondylopathia humeri radialis: a randomized controlled trial]. Forsch Komplementarmed Klass Naturheilkd 2004;11(2):93-7.
  14. Anderson RE, Seniscal C. A comparison of selected osteopathic treatment and relaxation for tension-type headaches. Headache 2006;46(8):1273-80. PubMed
  15. Noll DR, Degenhardt BF, Johnson JC, Burt SA. Immediate effects of osteopathic manipulative treatment in elderly patients with chronic obstructive pulmonary disease. J Am Osteopath Assoc 2008;108(5):251-9.
Keep reading

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Pharmacist Counseling Corner

Osteopathic Manipulation: Common Questions

What is Osteopathic Manipulation used for, and does it work?
People use Osteopathic Manipulation for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Osteopathic Manipulation for Back pain, Neck pain and Pregnancy-related pain. For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does Osteopathic Manipulation interact with prescription medications?
We do not currently list any known drug interactions for Osteopathic Manipulation. This does not guarantee that none exist, so always confirm with your pharmacist before combining it with your medications.
How are Osteopathic Manipulation interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Osteopathic Manipulation with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Osteopathic Manipulation interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Osteopathic Manipulation used for?
It is most often used for musculoskeletal pain, especially low back pain, neck pain, and tension headaches. It is also used to ease muscle and joint stiffness.
Is Osteopathic Manipulation safe?
It is generally low-risk when done by a trained, licensed provider, but it is not right for everyone. People with osteoporosis, fractures, certain spine or joint conditions, or bleeding problems should use caution.
Does it hurt?
Most techniques are gentle and not painful. Some people feel mild soreness or stiffness for a day or two afterward, which usually goes away on its own.
Is it safe during pregnancy?
Gentle techniques are sometimes used for pregnancy-related back and pelvic discomfort, but only by a provider experienced with pregnant patients. Check with your doctor first.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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