late 19th century. Relative contraindications for the use of lymphatic pump treatments include fractures, abscesses or localized infections, and severe bacterial infections with body temperature elevated higher than . Effectiveness A 2005 Cochrane review of osteopathic manipulative treatment (OMT) in asthma treatment concluded that there was insufficient evidence that OMT can be used to treat asthma. In 2013, a Cochrane review reviewed six randomized controlled trials which investigated the effect of four types of chest physiotherapy (including OMT) as adjunctive treatments for pneumonia in adults and concluded that "based on current limited evidence, chest physiotherapy might not be recommended as routine additional treatment for pneumonia in adults." Techniques investigated in the study included paraspinal inhibition, rib raising, and myofascial release. The review found that OMT did not reduce mortality and did not increase cure rate, but that OMT slightly reduced the duration of hospital stay and antibiotic use. A 2013 systematic review of the use of OMT for treating pediatric conditions concluded that its effectiveness was unproven. In 2014, a systematic review and meta-analysis of 15 randomized controlled trials found moderate-quality evidence that OMT reduces pain and improves functional status in acute and chronic nonspecific low back pain. The same analysis also found moderate-quality evidence for pain reduction for nonspecific low back pain in postpartum women and low-quality evidence for pain reduction in nonspecific low back pain in pregnant women. A 2013 systematic review found insufficient evidence to rate osteopathic manipulation for chronic nonspecific low back pain. In 2011, a systematic review found no compelling evidence that osteopathic manipulation was effective for the treatment of musculoskeletal pain. A 2018 systematic review found that there is no evidence for the reliability or specific efficacy of the techniques used in visceral osteopathy. The New England Journal of Medicines 4 November 1999 issue concluded that patients with chronic low back pain can be treated effectively with manipulation. The United Kingdom's National Health Service says there is "limited evidence" that osteopathy "may be effective for some types of neck, shoulder or lower limb pain and recovery after hip or knee operations", but that there is no evidence that osteopathy is effective as a treatment for health conditions unrelated to the bones and muscles. Others have concluded that there is insufficient evidence to suggest efficacy for osteopathic style manipulation in treating musculoskeletal pain. Criticism The American Medical Association listed DOs as "cultists" and deemed MD