Osteopathic Manipulative Treatment for Chronic Low Back Pain and Musculoskeletal Pain in Remote Underserved Populations: A Systematic Literature Review.

Chronic musculoskeletal pain, particularly chronic low back pain (CLBP), is a prevalent issue among rural populations, where limited access to healthcare exacerbates the condition and significantly impacts various aspects of daily life. The effects of chronic pain and healthcare barriers extend beyond physical health, influencing mental well-being, physical activity, and overall functionality as rural populations age. This complex healthcare challenge requires further investigation to identify effective, culturally relevant, and cost-efficient solutions. Proposed approaches include osteopathic manipulative treatment (OMT), telehealth, and alternative education models designed to incentivize healthcare professionals to serve these communities while respecting their cultural values and societal needs. Medical missions and volunteer healthcare efforts are already making strides in alleviating the impact of CLBP, which can lead to mental health decline, reduced mobility, and functional impairments. This systematic literature review synthesizes recent research on the effectiveness of OMT in managing chronic musculoskeletal pain, with a particular focus on low back pain (LBP) in underserved and rural populations. It examines how biopsychosocial factors and healthcare access influence treatment outcomes, while also proposing strategies for improving healthcare access through innovative education models and the use of technology. The review also considers the importance of community engagement and cultural sensitivity in these approaches. By analyzing research articles published between 2013 and 2023 from Google Scholar and PubMed, along with additional articles identified through a manual search of the  journal website, this review evaluates 26 relevant studies on the therapeutic benefits of OMT for CLBP. It aims to highlight the potential of OMT as an effective intervention for rural populations and to better understand the broader implications of chronic musculoskeletal pain on these communities.