Press "Enter" to skip to content

Osteopathy May Relieve Pain Associated with Musculoskeletal Disorders, New Review Says


A new review of the available clinical evidence, published in the journal BMJ Open, suggests that osteopathic manipulative treatment could be effective in the management of musculoskeletal disorders, specifically with regard to chronic non-specific low back pain patients and low back pain in pregnant or postpartum women.

Bagagiolo et al. performed a comprehensive literature search for evidence on the efficacy and safety of osteopathic manipulative treatment for any condition. Image credit: Jarmon_88.

Bagagiolo et al. performed a comprehensive literature search for evidence on the efficacy and safety of osteopathic manipulative treatment for any condition. Image credit: Jarmon_88.

Osteopathic medicine, depending on different legal and regulatory structures around the world, is a medical profession, an allied health profession or a part of complementary and alternative medicine, developed by Andrew Taylor Still in the 1800s in the Midwestern USA.

This therapy is based on the principle that the structure (anatomy) and function (physiology) of the individual’s body are closely integrated and that a person’s well-being depends on the balance of neurological, musculoskeletal and visceral structures.

Osteopathic medicine is provided on almost every continent, and in 2020, a survey estimated that 196,861 osteopathic practitioners provide osteopathic care worldwide in 46 countries.

It plays an important role primarily in musculoskeletal healthcare. A recent survey conducted in Switzerland on a sample of 1,144 patients showed that over 80% of patients had requested an osteopathic consultation for musculoskeletal pain (mainly low back pain, neck pain and headaches).

Similar results were reported by a survey conducted in the UK on a sample of approximately 1,600 patients with pain in the lumbar spine, cervical spine and pelvic region.

Finally, a prospective study on 14,000 patients in Quebec, Canada reported musculoskeletal pain, localised in the spine, thorax, pelvis and limbs as the most common reason for osteopathic consultations.

Osteopathic manipulative treatment is defined in the Glossary of Osteopathic Terminology as ‘the therapeutic application of manually guided forces by an osteopathic practitioner to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction.

It refers to a number of various types of approaches and techniques such as myofascial release, mobilisation, osteopathy in cranial field and visceral manipulation, in order to optimise the body’s normal self-regulating mechanisms.

“In recent years, a number of systematic reviews and meta-analyses have been published to evaluate the clinical efficacy and safety of osteopathic medicine for conditions such as low back pain, neck pain and migraine,” said lead author Dr. Donatella Bagagiolo from the Scuola Superiore di Osteopatia Italiana and her colleagues from Italy.

“However, due to differences in methodologies and the quality of systematic reviews, no clear conclusions were achieved.”

The researchers therefore wanted to assess the safety and effectiveness of osteopathic manipulative treatment for different conditions.

They trawled research databases for systematic reviews and meta analyses of relevant randomized controlled clinical trials, published up to November 2021. Only trials carried out by doctors with osteopathic training or osteopaths were included.

They uncovered 9 systematic reviews or meta analyses conducted between 2013 and 2020, involving 55 primary trials and 3,740 participants.

The systematic reviews reported on the use of osteopathy in a wide range of conditions, including acute and chronic non-specific low back pain, chronic non-specific neck pain, chronic non-cancer pain, primary headache, and irritable bowel syndrome.

The meta analyses reported that osteopathy is more effective than other approaches in reducing pain and improving physical function in acute/chronic non-specific lower back and neck pain and in chronic pain not associated with cancer.

The other comparative approaches included placebo, sham osteopathy, light touch therapy, no treatment, waiting list, conventional treatment, physiotherapy or other forms of complementary medicine.

But small sample size, contradictory findings, and wide variations in study design meant that the evidence on the effectiveness of osteopathy for use in children with various conditions, ranging from attention deficit hyperactivity disorder to asthma and infantile colic, and the treatment of migraine and irritable bowel syndrome, was limited or inconclusive.

No serious side effects associated with the therapy were reported in the 7 systematic reviews that evaluated them, although only two defined how these were measured.

“This overview suggests that osteopathy could be effective in the management of musculoskeletal disorders, specifically with regard to chronic non-specific low back pain and low back pain in pregnant women or those who have just had a baby,” the authors said.

“In contrast, inconclusive evidence was derived from systematic reviews analyzing osteopathy efficacy on pediatric conditions, primary headache, and irritable bowel syndrome.”

“Nevertheless, based on the low number of studies, some of which are of moderate quality, our overview highlights the need to perform further well-conducted systematic reviews as well as clinical trials (which have to follow the specific guidelines for non-pharmacological treatments) to confirm and extend the possible use of osteopathy in some conditions as well as its safety.”

_____

Donatella Bagagiolo et al. 2022. Efficacy and safety of osteopathic manipulative treatment: an overview of systematic reviews. BMJ Open 12: e053468; doi: 10.1136/bmjopen-2021-053468



Source link

Comments are closed.