Potential Adjunctive Role of Osteopathic Manipulative Medicine in the Management of Cancer-Related Bone Pain: A Narrative Review

Osteopathic manipulative medicine (OMM) is known for its therapeutic potential on the musculoskeletal system, and its emerging role and potential benefits in oncology care are gaining attention. Patients with primary and metastatic bone cancer tend to experience pain, restricted movement, and lower quality of life due to the pathology and its treatment. This narrative review examines the mechanistic rationale and available clinical evidence supporting the use of OMM in the management of pain and functional impairment among patients with bone malignancies. A literature search was conducted using PubMed and Google Scholar to identify peer-reviewed studies published between 2005 and 2025 addressing OMM interventions in oncologic and bone cancer populations. Relevant clinical and mechanistic studies were synthesized to evaluate potential therapeutic roles and safety considerations. Limited clinical studies suggest that select OMM techniques, including myofascial release (MFR), gentle soft tissue methods, and lymphatic approaches, may contribute to improvements in pain perception, mobility, and fatigue in oncology populations. Evidence specific to primary bone malignancies remains sparse, with most data derived from small trials, observational studies, and extrapolation from broader cancer cohorts. OMM may offer a non-pharmacologic adjunct targeting biomechanical dysfunction, autonomic regulation, and lymphatic flow, which are implicated in cancer-related pain and functional decline. However, heterogeneity in study design, small sample sizes, and limited bone-specific data constrain definitive conclusions. Current evidence suggests that OMM has potential as a supportive modality in bone cancer care, particularly for symptom management and functional rehabilitation. Rigorous, well-designed clinical trials are needed to establish safety parameters, standardized protocols, and efficacy within this population.