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Osteopathic interventions appear to
be valuable to manage patients having chronic low back pain.
The findings of a study demonstrated that osteopathic interventions are very effective in reducing pain levels and improving the functional status of patients suffering from chronic non-specific low back pain. Compared to other interventions, the myofascial release was found to display a better level of evidence for pain reduction.
A systematic review and meta-analysis were carried out to explore the efficacy of osteopathy to treat chronic low back pain. Considering the PRISMA statement, the findings were reported. Six databases were extensively searched for the relevant randomized controlled trial (RCTs). The primary endpoint was an improvement in pain and functional status (disability), estimated at post-intervention and follow-up.
The studies were independently examined utilizing a standardized form. Each article was evaluated utilizing the Cochrane risk of bias tool. The effect size (ES) was estimated after the intervention and at 12 weeks’ follow-up. To determine the quality of evidence, GRADE was utilized.
The study incorporated 10 articles. The studies evaluated osteopathic manipulative treatment (OMT, n=6), craniosacral treatment (CST, n=1), myofascial release (n=2), and osteopathic visceral manipulation (n=1). None of the analyses was fully judged at low risk of bias.
Osteopathy depicted superior efficacy compared to the control interventions in alleviating pain (ES: -0.59) and in improving functional status (ES: -0.42). Moderate-quality evidence illustrated better efficacy of myofascial release in comparison with other osteopathic modalities in diminishing pain (ES: -0.69), even at follow-up (ES: -0.73).
Low-quality evidence depicted OMT superiority in pain reduction (ES: -0.57) and in enhancing functional status (ES: -0.34). Very low-quality evidence demonstrated that myofascial release has better efficacy compared to control interventions in functional improvements (ES: -0.73).
Thus, osteopathic modalities may substantially improve pain and functional
status in chronic low back pain patients. However, further high-quality and
robust RCTs should focus on comparing different osteopathic modalities to
generate better-quality evidence.
Complementary Therapies in Medicine
Effectiveness of Osteopathic Interventions in Chronic Non-Specific Low Back Pain: a Systematic Review and Meta-Analysis
Fulvio Dal Farra et al.
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