Researchers Find Patients with Moderate to Severe Pain and Disability Derive Most Benefit
CHICAGO—February 29, 2016— Studies published in The Journal of the American Osteopathic Association found that osteopathic manipulative treatment (OMT) reduced pain and improved function in patients suffering from chronic, nonspecific low back pain. Further, patients reporting the worst pain and higher degrees of disability received the most substantial benefit from the treatments.
Researchers from the University of North Texas Health Science Center in Fort Worth reported two studies from a randomized double-blind, sham-controlled trial to determine the effectiveness of six OMT sessions over an eight week period. Recovery was assessed at week 12 using a composite measure that included pain severity and functional status. The trial included 455 men and women ages 21-69 with at least a three month history of low back pain.
While the initial study was intended to measure whether OMT aided in recovery, the second study sought to identify characteristics of patients who received the most benefit from the treatments. It found patients with baseline disability scores of 17 or greater, on a scale of 24, experienced large positive effects and those with initial scores of 7 or greater experienced medium effects.
Substantial benefit was defined as an improvement of 50 percent or more from the baseline pain and disability assessment. The findings led researchers to suggest patients try OMT before resorting to surgery.
“Subgrouping patients according to chronic low back pain intensity and function appears to be a simple strategy for identifying patients who can attain substantial improvement with OMT. From a cost and safety perspective, OMT should be considered before progressing to more costly or invasive interventions,” said John C. Licciardone, DO, MS, MBA.
a The median (IQR) baseline values for recovered and nonrecovered patients, respectively, at week 12 in the primary analysis were 35 (22-47) vs 52 (37-65) on the visual analog scale for low back pain (LBP) intensity (P<.001); 5 (4-7) vs 7 (4-12) on the Roland Morris Disability Questionnaire (P<.001); and 75 (62-82) vs 67 (45-80) on the general health scale of the Medical Outcomes Study Short Form-36 Health Survey (P=.02). Similar findings were observed in the sensitivity analysis.
b The No. (%) represent those with the given characteristic among the 48 and 80 patients, respectively, who achieved recovery in the primary analysis and sensitivity analysis.
c The ORs are adjusted for each variable in the table. The ORs are for each 1-mm increment on the 100-mm visual analog scale and for each 1-unit increment on the Roland Morris Disability Questionnaire and general health scale of the Medical Outcomes Study Short Form-36 Health Survey.
However, researchers did not find OMT to be beneficial in patients with clinical depression.
The full studies are available online:
About The Journal of the American Osteopathic Association
The Journal of the American Osteopathic Association (JAOA) is the official scientific publication of the American Osteopathic Association. Edited by Robert Orenstein, DO, it is the premier scholarly peer-reviewed publication of the osteopathic medical profession. The JAOA’s mission is to advance medicine through the publication of peer-reviewed osteopathic research.
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