The Role of Osteopathy in the Early Diagnosis and Management of Degenerative Cervical Myelopathy: a National Survey of Osteoapths (Preprint)

BACKGROUND Degenerative cervical myelopathy (DCM) is a common and disabling neurodegenerative condition. Surgical decompression is the only evidence-based treatment to halt disease progression, however diagnosis and access to timely treatment is often delayed. This contributes to significant disability and dependence. Supporting early diagnosis and access to timely treatment is a critical priority. Exploring these challenges, Myelopathy.org has observed that people with DCM may seek osteopathy care for their symptoms, both before and after diagnosis. OBJECTIVE This study aimed to describe the current interaction between osteopaths and people with DCM and understand how this may be targeted to enhance the DCM diagnostic pathway. METHODS Registered osteopaths completed a web-based survey hosted by the Institute of Osteopathy, as part of their institute’s 2021 census. Demographic information about respondents was captured, including age, gender, and ethnicity. Professional information captured included year of qualification, region of practice, type of practice and the number of undiagnosed, operated diagnosed and unoperated diagnosed DCM cases encountered per year. RESULTS The demographics were heterogenous for the 547 practitioners who completed the survey. At least 69% of osteopaths reported encounters with DCM each year. Osteopaths most frequently encountered undiagnosed DCM patients, with a mean of 3 patient encounters per year. This compares to 2 encounters per year with diagnosed DCM patients. Level of practitioner experience was positively correlated with the detection of undiagnosed DCM. CONCLUSIONS As a concentration point for encounters with undiagnosed DCM and a specialist workforce, osteopaths may offer a unique opportunity to accelerate DCM diagnosis. We include a decision support tool and specialist referral template as a tool to support onward care.