Disclosures: Nguyen reports no relevant financial disclosures.
March 17, 2021
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Osteopathic manipulative treatment had small effect on low back pain

Disclosures: Nguyen reports no relevant financial disclosures.
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Published results showed standard osteopathic manipulative treatment for nonspecific subacute or chronic low back pain had a small effect on low back pain-specific activity limitations compared with sham osteopathic manipulative treatment.

Christelle Nguyen, MD, PhD, and colleagues randomly assigned 400 participants with nonspecific subacute or chronic low back pain to receive either 6 weeks of standard osteopathic manipulative treatment (OMT; n=200) or sham OMT (n=200) delivered by non-physician, non-physiotherapist osteopathic practitioners. Researchers used the self-administered Quebec Back Pain Disability Index to measure mean reduction in low back pain-specific activity limitations at 3 months as the primary end point. Secondary outcomes included mean reduction in low back pain-specific activity limitations, mean changes in pain and health-related quality of life, number and duration of sick leave, as well as number of low back pain episodes at 12 months, and consumption of analgesics and NSAIDs at 3 and 12 months. Researchers also collected self-reported adverse events at 3, 6 and 12 months.

Among the 197 participants analyzed in each group, results showed a mean duration of current low back pain episode of 7.5 months. Researchers found mean Quebec Back Pain Disability Index scores of 31.5 at baseline and 25.3 at 3 months in the standard OMT group vs. 27.2 at baseline and 26.1 at 3 months in the sham OMT group. Participants who received standard OMT had a mean reduction in low back pain-specific activity limitations of –4.7 at 3 months vs. –1.3 in the sham OMT group, results showed. Researchers found a mean difference in mean reduction in low back pain-specific activity limitations of –4.3 at 12 months, as well as a mean difference in mean reduction in pain of –1 at 3 and 12 months. Participants had no statistically significant differences in other secondary outcomes, according to researchers. Results showed participants in the standard and sham OMT groups self-reported four and eight serious adverse events, respectively, although none were considered related to OMT.

Christelle Nguyen
Christelle Nguyen

“Osteopathic manipulative treatment has a small, but likely not clinically meaningful, effect on low back pain-specific activity limitations vs. sham treatment at 3 and 12 months. We found no evidence of effect on pain and health-related quality of life,” Nguyen told Healio Orthopedics. “Our results question the usefulness of osteopathic manipulative treatment in people with nonspecific subacute and chronic low back pain.”