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