Osteopathic Manipulative Treatment for Low Back Pain: a systematic review and meta-analysis of randomized controlled trials

Osteopathic Manipulative Treatment (OMT) significantly reduces low back pain. The level of pain reduction is greater than expected from placebo effects alone and persists for at least three months. Additional research is warranted to elucidate mechanistically how OMT exerts its effects, to determine if OMT benefits are long lasting, and to assess the cost-effectiveness of OMT as a complementary treatment for low back pain.

Background

Osteopathic manipulative treatment is a distinctive modality commonly used by osteopaths to complement their conventional treatment of musculoskeletal disorders. Previous reviews and meta-analyses of spinal manipulation for low back pain have not specifically addressed OMT and generally have focused on spinal manipulation as an alternative to conventional treatment. The purpose of this study was to assess the efficacy of OMT as a complementary treatment for low back pain.

Methods

Computerised bibliographic searches of MEDLINE, EMBASE, MANTIS, OSTMED, and the Cochrane Central Register of Controlled Trials were supplemented with additional database and manual searches of the literature.

Computerised bibliographic searches of MEDLINE, EMBASE, MANTIS, OSTMED, and the Cochrane Central Register of Controlled Trials were supplemented with additional database and manual searches of the literature.

Six trials, involving eight OMT vs control treatment comparisons, were included because they were randomized controlled trials of OMT that involved blinded assessment of low back pain in ambulatory settings. Data on trial methodology, OMT and control treatments, and low back pain outcomes were abstracted by two independent reviewers. Effect sizes were computed using Cohen’s d statistic and meta-analysis results were weighted by the inverse variance of individual comparisons. In addition to the overall meta-analysis, stratified meta-analyses were performed according to control treatment, country where the trial was conducted, and duration of follow-up. Sensitivity analyses were performed for both the overall and stratified meta-analyses.

Results

Overall, OMT significantly reduced low back pain (effect size, -0.30; 95% confidence interval, -0.47 – -0.13; P = .001). Stratified analyses demonstrated significant pain reductions in trials of OMT vs active treatment or placebo control and OMT vs no treatment control. There were significant pain reductions with OMT regardless of whether trials were performed in the United Kingdom or the United States. Significant pain reductions were also observed during short-, intermediate-, and long-term follow-up.

About David Drysdale

David Drysdale has worked as an Osteopath in the West End of Glasgow since 1996. David combines a wide range of techniques when treating a patient, ranging from Osteopathic Manipulation, Massage, Trigger Point Therapy, Cranio-Sacral Therapy, Nutrition and Exercise. Treatments are tailored for the Patient. It is understood that some people simply do not like osteopathic manipulation, while others like Deep Tissue Massage, or benefit from Cranio-Sacral Therapy. There are different ways of treating people who are in pain, and providing the treatment that works for you is very important. Osteopathy is well known for treating Headaches, Neck & Back Pain, but many other conditions such as migraines, frozen shoulder and arthritis can all respond well to good Osteopathic treatment.
This entry was posted in Cochrane Reports, Osteopathy, Spinal Manipulation. Bookmark the permalink.

Many Thanks…………….. Davy Drysdale

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