Painaustralia member and Guest contributor Osteopathy Australia introduces advanced recognition in pain management as a novel approach to delivering quality health outcomes

By Peter Lalli, Senior Policy Officer- Clinical Excellence
E: clinicalpolicy@osteopathy.org.au

Most of the readership is aware of the ever increasing social, economic and personal costs of persistent pain. 

As the national peak body for osteopaths, we are very aware of the wall traditional manual therapy approaches come up against for pain management. A cursory review of the pain evidence base repeatedly shows the typical manual therapies cited in physiotherapy, osteopathic, and chiropractic studies--- mobilisation and manipulation techniques--- have primary efficacy in management of acute pain.

In the persistent phase, the situation differs. When used alone, manual techniques do not show durable results for persistent pain with a neurological component, no matter how much committed acolytes would wish. Beyond the efficacy side, dependency, passivity and loss of empowerment can result for the patient offered manual therapy alone. Clearly, change is needed in the musculoskeletal clinical disciplines to bring appropriate clinical personnel to forefront of care. We have risen to this task, promoting osteopaths demonstrating a strong capacity to practice pain models focusing on non-mechanical pain.

In late 2019, we introduced ‘advanced recognition’ in pain management after years of planning, consulting with IASP, Painaustralia, and other health professional groups. It has not been an easy process, but we now have a pain quality framework outlining standards for practitioners seeking advanced recognition and quality audit systems capturing data around the standards for benchmarking candidates. 

Our recognition process is serious business – not only does it review candidates for further education and career background in pain management, it has a strong focus on validated quality in the pain care delivery process and practice outcomes. Further, we engage top multidisciplinary practitioners in the field to facilitate reviews for impartiality and to assure a candidate’s suitability. We have gone beyond typical advanced recognition models, where members of a single profession often peer review one another. This is all to give patients who choose an osteopath appropriate choice of practitioner for their pain needs and bolster confidence in health professionals seeking local clinical coordination.

Osteopaths with advanced recognition must demonstrate extensive awareness of, and capacity, to provide a range of skilled pain management services, for instance:

• Multimodal pain assessments and differential diagnoses; neurological examinations and sensitisation tests for pain; suitability assessments for referral to specialty pain clinics
• Multimodal interventions, with an emphasis on working with other health professionals to address problem behaviours and beliefs, creating education programs, designing and prescribing pain sensitive clinical exercise programs, prescribing desensitisation activities, daily routine planning, advising on movement and lifestyle adaptations for flair up minimisation or avoidance, pacing approaches.

Importantly, these osteopaths must understand the contributions of other health professionals in the pain management context and precisely when to refer; they value your professional contribution and recognise its crucial place.

We anticipate these osteopaths will make an enhanced contribution to offsetting the impact of complex pain types like neuropathic pain and comorbid pain in their local communities.

You will be able to recognise them by their professional title of ‘Advanced Pain Management Osteopath’, or via the unique logos they display at their clinics, on websites and business cards. You can also seek them out directly on our member database: https://osteopathy.org.au/find-an-osteo

Osteopathy Australia congratulates the first successfully recognised cohort of Advanced Pain Management Osteopaths from 2019: Pamela Dennis, Annabel Ranford, Claire Richardson, Alison Sim, and Terry Stewart.