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To the Editor, I almost didn’t read the September 2010 issue of JAOA—The Journal of the American Osteopathic Association because the table of contents suggested little in the way of osteopathic principles and practice, my main professional interest. However, I got trapped into reading the letters to the editor—especially those by Todd R. Fredricks, DO,1 and Zachary Comeaux, DO.2 These letters had been written in regard to an earlier letter by Eric E. Shore, DO, JD, MBA,3 who also wrote a response4 to the letters by Drs Fredricks1 and Comeaux.2 We do not seem capable of resolving this ongoing controversy over the identity of the osteopathic medical profession vs the allopathic medical profession. This controversy has been wasting our energies since I entered the osteopathic medical profession in 1952 as a student, and we are no further ahead now than we were then in settling the matter. What would it take to agree to a moratorium on this debate? My attention having been captured by these letters, I moved on to the main articles in the JAOA that I was interested in. The original contribution on combat-related posttraumatic headache by CPT Matthew P. Kozminski, DO, MC, USA,5 struck a familiar note. I was an active-duty Marine during the Korean War, an active Marine Reservist for the next 14 years, and a Reserve Navy medical officer serving Marine Reservists for 19 years after that. While serving in these capacities, I saw, diagnosed, and treated many patients who had head and cervicothoracic distress. Although I identified several causes for the headaches, the most common etiologic factor by far was the wearing of military equipment, especially the World War II–type steel helmet. The cervicothoracic problems of many of my patients were also associated with the prolonged carrying of backpacks. I know that the protective equipment for military personnel has since been improved, both in terms of individual protection and “wearability.” However, I have learned recently from television news reports that it is common for soldiers in combat areas to carry a total weight of up to 80 pounds (36 kg) for extended missions of 8 hours or more. Wearing such heavy loads for such a long time, along with causing the obvious excessive fatigue, is clearly likely to induce sufficient stress in the cervical and upper thoracic areas to give rise to headache. Although our military personnel may not be able to avoid this trauma, osteopathic physicians should recognize the trauma as an important contributory factor to headache among these individuals and give it some priority in our diagnosis and treatment. Osteopathic physicians view occupational and “overuse” stresses and other recurrent stresses as important etiologic factors in a variety of musculoskeletal complaints of patients. The increased incidence of carpal tunnel syndrome since the widespread use of comAs the premier scholarly publication of the osteopathic medical profession, JAOA—The Journal of the American Osteopathic Association encourages osteopathic physicians, faculty members and students at colleges of osteopathic medicine, and others within the healthcare professions to submit comments related to articles published in the JAOA and the mission of the osteopathic medical profession. The JAOA’s editors are particularly interested in letters that discuss recently published original research. Letters to the editor are considered for publication in the JAOA with the understanding that they have not been published elsewhere and that they are not simultaneously under consideration by any other publication. All accepted letters to the editor are subject to editing and abridgement. Letter writers may be asked to provide JAOA staff with photocopies of referenced material so that the references themselves and statements cited may be verified. Readers are encouraged to prepare letters electronically in Microsoft Word (.doc) or in plain (.txt) or rich text (.rtf) format. The JAOA prefers that readers e-mail letters to jaoa@osteopathic.org. Mailed letters should be addressed to Gilbert E. D’Alonzo, Jr, DO, Editor in Chief, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864. Letter writers must include their full professional titles and affiliations, complete preferred mailing address, day and evening telephone numbers, fax numbers, and email address. In addition, writers are responsible for disclosing financial associations and other conflicts of interest. Although the JAOA cannot acknowledge the receipt of letters, a JAOA staff member will notify writers whose letters have been accepted for publication. Mailed submissions and supporting materials will not be returned unless letter writers provide self-addressed, stamped envelopes with their submissions. All osteopathic physicians who have letters published in the JAOA receive continuing medical education (CME) credit for their contributions. Writers of original letters receive 5 hours of AOA Category 1-B CME credit. Authors of published articles who respond to letters about their research receive 3 hours of Category 1-B CME credit for their responses. Although the JAOA welcomes letters to the editor, readers should be aware that these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows. LETTERS

Osteopathic Issues Raised by the September 2010 JAOA