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Osteopathy 'reduces low back pain'

Treating patients with chronic low back pain with a course of osteopathy is effective at reducing pain in the short-term, say researchers.

The study

Some 455 patients with low back pain that had been present for at least three months were randomised to receive either osteopathy plus ultrasound, osteopathy plus sham ultrasound, sham osteopathy plus ultrasound or sham osteopathy plus sham ultrasound. Sham osteopathy consisted of techniques similar to genuine osteopathy, but with decreased force and incorrect positioning. Pain was measured on a visual analogue scale (VAS), with moderate reduction in pain defined as a 30% or greater reduction and substantial defined as a 50% or greater reduction. Patients had six treatment sessions over the 12-week study period and were allowed to take non-prescription medications and usual low back pain care in addition.

The findings

Osteopathy significantly reduced pain scores at 12 weeks, compared with sham osteopathy. VAS scores in patients undergoing genuine osteopathy decreased by a median of 18, compared with a median of nine in those treated with sham osteopathy. There was no significant difference between the ultrasound and sham ultrasound groups in reducing pain. Some 63% of the osteopathy group reported a moderate improvement in pain, compared with 46% of the sham osteopathy group at week 12. Half of the osteopathy group reported a substantial improvement, compared with 35% of those in the sham treatment group.

What does it mean for GPs?

The US authors concluded that these results ‘support the efficacy and safety of osteopathy, however they do not address its cost-effectiveness’. They added that the treatment regimen used in this study ‘was within the guidelines developed in the UK by NICE, which recommend up to nine spinal manipulation treatment sessions over 12 weeks.’

Annals of Family Medicine 2013, online March

Readers' comments (5)

  • Osteopaths who are properly trained and accredited are excellent. But not all Osteopaths practising in the UK are registered. There are several who are "sham" probably comparable to the 455 patient study and will not get the results compared to the treated group.

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  • My experience on outcomes with osteopathy is far better and affords quicker recovery then physiotherapy in general. I find that before ordering diagnostics like MRi and X-rays it is worth trying osteopathy or physio as appropriate and this is far more cost effective and therapeutic .Patient education is far important then sticking to the ' nine sessions trestment reginen as 'recommended.

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  • All Osteopaths practising in the UK are regulated by the General Osteopathic Council, a statutory body. Anyone who is claiming to be an Osteopath or to practise Osteopathy who is not registered with GOsC should be reported to them.

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  • It is a criminal offence to call yourself an osteopath if you are not on the statutory register. If you know as a fact that someone is claiming to be an osteopath (I think you made reference to "several who are 'sham'") I would ask you to report this to the General Osteopathic Council who will begin legal proceedings against them.

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  • I'm not sure how osteopaths are in the UK, but in the US, most do not perform OMT. The few who do are very good at it, but the majority would send to a chiropractor, like myself. Not all chiropractors are the same, but most modern chiropractors follow a biomechanical model that maximizes the function of the individual spinal segments allowing the spine to move better and distribute stress better which decreases pain. This is precisely what appears to be happening in this study that has been mentioned, but it was performed by osteopaths. It could just as well been performed by chiropractors and many studies have been done to authenticate similar outcomes.

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