PM&R: The Journal of Injury, Function and Rehabilitation, 2024/11, 16(S1):S58–S59. doi: 10.1002/pmrj.13305, type of study: ,ret,,,,,,,,,,,,,,,,,,,

Full text    (https://onlinelibrary.wiley.com/doi/10.1002/pmrj.13305)

Keywords:

conference abstract [127]
injections [7]
low back pain [523]
OMT [3924]
osteopathic manipulative treatment [3945]
retrospective study [339]

Abstract:

Background and/or Objectives: Low back pain (LBP) is the leading cause of disability worldwide, carrying a steep economic and medical burden. This study aims to compare the effectiveness of osteopathic manipulative treatment (OMT) and trigger point injections (TPI) in managing LBP. Design: Case-control retrospective cohort analysis. Setting: We used the TriNetX Database, which contains de-identified electronic health record data from across the United States, to select patients with diagnosis of LBP. This study is exempt from IRB review as determined by the University of Texas Medical Branch IRB. Participants: Cohort A (OMT, 2,227 patients; mean age of 54.4 17.0 years) and Cohort B (TPI, 2,227 patients; mean age of 54.6 17.1) after propensity score matching. Both cohorts were diagnosed with lower back strain. Interventions: Cohort A received OMT, while Cohort B underwent TPI within one month of diagnosis of low back pain. Main Outcome Measures: Our study measured emergency room visits, lumbar spine imaging, physical therapy evaluations, epidural injections, and new diagnoses of lumbar spinal stenosis or herniated discs. Medication usage patterns, including opioids and nerve pain medications, were also analyzed. Cohorts were matched for potential confounding variables. Results: Analysis revealed that the TPI cohort had a 28.2% rate of ER visits compared to 19.4% in the OMT group. Further lumbar spine imaging requirements were observed in 2.2% of TPI patients against 1.0% in OMT. Diagnosis of lumbar spinal stenosis was 11.7% in TPI, compared to 8.7% in OMT. Opioid use was markedly higher in TPI at 30.1%, versus 22.9% in OMT. Conclusions: The study highlights distinct differences in healthcare utilization and outcomes between OMT and TPI treatments for LBP. It underscores the importance of individualized treatment plans in the clinical management of LBP and demonstrates the need for further cost of care analysis.