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Retrospective Outcome Analysis of Osteopathic Manipulation in a Treatment Failure Setting
Gronemeyer, J. [1]
Audette, J. F. [1]
Drexler, J. H. [1]
Haugh, J. [1]

Journal: The Journal of the American Osteopathic Association Date: 2006/08, 106(8):Pages: 494. doi: Subito , type of study: retrospective study

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2006.106.8.471/html)

Keywords:

chronic pain [286]
cranio-sacral osteopathy [220]
low back pain [485]
neck pain [157]
retrospective study [307]

Abstract:

This study was initiated to confirm a pattern of clinical improvement that was observed in a group of chronic pain patients when Osteopathic treatment was added to their treatment protocol. Hypothesis: Osteopathic Manipulation in the Cranial Field integrated with physical therapy can positively influence functional and pain outcomes for patients with chronic neck and back pain with a history of treatment failure utilizing standard pain interventions and physical therapy alone. Methods: The charts of 150 consecutive patients referred for osteopathic care in a major tertiary Pain Center were reviewed for inclusion in the outcome analysis. 40 patients met the inclusion criteria that included a history of cervical or lumbar pain of duration longer than 6 months with treatment failures in other Interventional Pain and Rehabilitation settings in the Boston metropolitan area. Exclusion criteria included use of high dose opioid medications, prior osteopathic manipulation, and outstanding litigation. Outcomes included numeric pain scores on a 10 point scale and assessment of functional capacity using a 5 point scale graded by both the patient and physical therapist. A score of 1 represents poor function, 2 represents fair function, 3 represents moderate function, 4 represents good function, and 5 represents excellent function. Assessments were done by the treating physical therapist as well by the patient's self-assessment before initiating treatment, at the end of treatment and at 6 month follow up by phone call. Standard pain management was provided by the attending Physiatrist. Additional treatment involved 3 to 10 sessions of osteopathic manipulation in the cranial field using balanced ligamentous tension by the primary author combined with a course of physical therapy working on progressive stretching and strengthening of postural stabilizing muscles. Results: Retrospectively, there were significant improvements seen in pain scores and functional scores pre and post treatment. The mean pain score at the start of treatment was 5.76 and at the completion of treatment 2.05 (P 0.003). PT rated function was moderate or less at the start of treatment (mean 39.02). At the conclusion of treatment a function rating of good or excellent function in 85% of the participants (mean 74.39, P 0.006). At 6 months follow-up, only 30% of the subjects responded to a telephone assessment of pain and function. Of those that responded, 92% had maintained their post treatment function or had improved function. The average pain score remained low at 2.4. Conclusion: This retrospective outcome assessment suggests that the inclusion of osteopathic manipulation in the cranial field integrated with physical therapy may have a significant effect on reversing treatment failures in patients with chronic neck and low back pain.

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