Back Pain


Approach to low back pain – osteopathy

Vaughan B, Morrison T, Buttigieg S, Macfarlane C, Fryer G.

Published in Australian Family Physician 2014, Vol43, No.4, April 2014 Pages 197-198

This article forms part of our allied health series for 2014, which aims to provide information about the management approach of different allied health professionals, using the case example of uncomplicated, mechanical low back pain.

A randomized, controlled trial of osteopathic manipulative treatment for acute low back pain in active duty military personnel.

Cruser dA, Maurer D, Hensel K, Brown SK, White K, Stoll ST.

Published in the Journal of Manual and Manipulative Therapy, 2012 Feb; 20(1):5-15.

This study supports the effectiveness of osteopathic manipulative treatment in reducing acute low back pain in active duty military personnel.

Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial.

Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP.

Published in Annals of Family Medicine

The osteopathic manipulative treatment regimen met or exceeded the Cochrane Back Review Group criterion for a medium effect size in relieving chronic low back pain. It was safe, parsimonious, and well accepted by patients.

Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials.

JC Licciardone, AK Brimhall and LN King

OMT significantly reduces low back pain. The level of pain reduction is greater than expected from placebo effects alone and persists for at least three months. Additional research is warranted to elucidate mechanistically how OMT exerts its effects, to determine if OMT benefits are long lasting, and to assess the cost-effectiveness of OMT as a complementary treatment for low back pain.

Outcomes of osteopathic manual treatment for chronic low back pain according to baseline pain severity.

Licciardone JC, Kearns CM, Minotti DE.

The large effect size for OMT in providing substantial pain reduction in patients with chronic LBP of high severity was associated with clinically important improvement in back-specific functioning. Thus, OMT may be an attractive option in such patients before proceeding to more invasive and costly treatments.

Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis.

Helge Franke, Jan-David Franke and Gary Fryer

Published in BMC Musculoskeletal Disorders 2014

Clinically relevant effects of osteopathic manipulative treatment were found for reducing pain and improving functional status in patients with acute and chronic nonspecific low back pain and for low back pain in pregnant and postpartum women at 3 months posttreatment. However, larger, high-quality randomized controlled trials with robust comparison groups are recommended.

Osteopathic manipulative treatment in obese patients with chronic low back pain: a pilot study.

Vismara L, Cimolin V, Menegoni F, Zaina F, Galli M, Negrini S, Villa V, Capodaglio P.

Published in Manual Therapy

Combined rehabilitation treatment including osteopathic manipulative treatment showed to be effective in improving biomechanical parameters of the thoracic spine in obese patients with chronic low back pain.

Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care.

Williams NH, Wilkinson C, Russell I, Edwards RT, Hibbs R, Linck P, Muntz R.

Published in Family Practice

Aim: was to assess the effectiveness and health care costs of a practice-based osteopathy clinic for subacute spinal pain. A primary care osteopathy clinic improved short-term physical and longer term psychological outcomes, at little extra cost. Rigorous multicentre studies are now needed to assess the generalizability of this approach.

Immediate effects of region-specific and non-region-specific spinal manipulative therapy in patients with chronic low back pain: a randomized controlled trial.

de Oliveira RF, Liebano RE, Costa Lda C, Rissato LL, Costa LO.

Published in Physical Therapy

The immediate changes in pain intensity and pressure pain threshold after a single high-velocity manipulation do not differ by region-specific versus non-region-specific manipulation techniques in patients with chronic low back pain.

Red flags to screen for malignancy and fracture in patients with low back pain: systematic review.

Downie A, Williams CM, Henschke N, Hancock MJ, Ostelo RW, de Vet HC, Macaskill P, Irwig L, van Tulder MW, Koes BW, Maher CG.

Published in BMJ

While several red flags are endorsed in guidelines to screen for fracture or malignancy, only a small subset of these have evidence that they are indeed informative. These findings suggest a need for revision of many current guidelines.

Osteopathic intervention in chronic non-specific low back pain: a systematic review.

Paul J Orrock and Stephen P Myers

One trial concluded similarity of effect between osteopathic intervention, exercise and physiotherap and the other was similar in effect to a sham intervention. Further clinical trials into this subject are required that have consistent and rigorous methods.

Nonpharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline.

Roger Chou, MD; and Laurie Hoyt Huffman, MS

Therapies with good evidence of moderate efficacy for chronic or subacute low back pain are cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation.In 1 study of primary care clinicians, 65% reported recommending massage therapy and 22% recommended, prescribed, or performed spinal manipulation.