The effects of osteopathic manipulative treatment on pain and disability in patients with chronic low back pain: a single-blinded randomised controlled trial
Low back pain is one of the most prevalent and costly conditions and is the leading cause of disability globally. Chronic low back pain (lasting for 3 months or longer) carries a significant burden. It has been estimated that over half a billion people across the globe suffer from chronic low back pain yearly. The most common form is considered nonspecific, which excludes back pain attributed to a specific pathology.
Clinical guidelines report a conservative, noninvasive approach to manage chronic, non-specific back pain. Although there is variation among numerous international clinical practice guidelines, commonly these guildlines recommend conservative treatment of - nonsteroidal anti-inflammatories (NSAIDs), exercise and manual therapy, and psychosocial therapy. Of manual therapy, guidelines mention spinal manipulative therapy. Joint mobilisation performed by physical therapists, and osteopathic manipulative treatment (OMT) performed by osteopaths and physicians, are all lumped under the umbrella of spinal manipulative therapy.
Osteopathic medicine is a musculo branch of medical practice in the United States, and physicians receive training in OMT that incorporates the therapeutic application of manual therapy as part of a whole-person approach to patient care. OMT is utilised frequently for low back pain management by osteopaths in the United States. Within the UK and Europe, registered osteopaths required to take a intensive clinical based 4 year degree programme to become registered. OMT employs numerous manual techniques such as high-velocity low-amplitude (HVLA) thrust, soft tissue, myofascial release, muscle energy, articulatory, and counterstrain techniques, depending on the diagnosed musculoskeletal dysfunction and osteopath's preference.
Based on 15 studies, the American Osteopathic Association guidelines state that OMT is regularly used to effectively reduce pain and improve function in patients with acute and chronic nonspecific low back pain, which is further corroborated by a systematic review and meta-analysis. The purpose of this study is to further investigate the efficacy of OMT in reducing pain and disability for chronic LBP with a randomised controlled trial.
The results from the current study indicate that OMT is effective in reducing pain in patients with chronic low back pain, as compared to a control group. The participants receiving OMT also showed significant improvements in secondary outcomes manifested in reduced anxiety scores. Considering the holistic, whole-person approach to treating patients is embraced by the osteopathic profession, such findings highlight the potential for OMT to affect multiple mechanistic pathways involved in treating neuromusculoskeletal conditions, particularly multifactorial conditions like back pain.
It has also previously been reported that patients with chronic low back pain who were treated by osteopaths who utilised OMT reported a significant decrease in the use of NSAIDs or opioid drugs.
In conclusion, this recent study demonstrated that osteopatic manipulation therapy effectively reduces pain and anxiety, along with improving sleep in patients with chronic low back pain. In addition, treatment with OMT in patients with low back pain is safe because there were no adverse reactions. Therefore, OMT should be utilised to care for patients with low back pain.
Please find study available here.
Get in touch to find out more. Here at Dynamic Osteopaths, we have back pain clinic in Birmingham and Warwickshire.
Dynamic Osteopaths
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