From the Guidelines
Osteopathic manipulative treatment (OMT) is effective for treating certain musculoskeletal conditions, particularly low back pain, as evidenced by clinical studies showing significant pain relief and improved function in patients with back pain, neck pain, and some types of headaches. The effectiveness of OMT varies by condition, with stronger evidence for back pain than for other conditions 1. Research demonstrates that OMT techniques like soft tissue manipulation, joint mobilization, and muscle energy techniques can reduce pain scores and decrease medication use in many patients.
Key Findings
- A systematic review found that spinal manipulation had small, statistically nonsignificant effects on pain at 1 month compared with sham manipulation, but was associated with better short-term pain relief at 1 month and 6 months compared with other active interventions 1.
- Compared with other active interventions, manipulation was associated with greater improvement in function at 1 month, although the effects were smaller and no longer statistically significant at 6 and 12 months 1.
- A good-quality trial found that spinal manipulation plus home exercise and advice resulted in greater improvement in leg and back pain at 12 weeks than home exercise and advice alone, although the effects were smaller and not statistically significant at 52 weeks 1.
Mechanisms of Action
Osteopathy works through several mechanisms, including:
- Improving joint mobility
- Enhancing circulation
- Reducing muscle tension
- Potentially influencing the body's nervous system response to pain
Treatment Recommendations
For optimal results, osteopathic treatment is often most effective when combined with appropriate exercise, proper body mechanics, and addressing contributing lifestyle factors rather than being used in isolation. Many patients experience relief after 4-6 sessions, typically scheduled weekly at first. While not every patient responds the same way, the evidence supports the use of OMT as a viable treatment option for certain musculoskeletal conditions, particularly low back pain 1.
From the Research
Effectiveness of Osteopathic Manipulative Treatment
The effectiveness of osteopathic manipulative treatment (OMT) is supported by several studies, including:
- A 2018 study published in FP essentials, which found that evidence supports the effectiveness of OMT in the management of musculoskeletal conditions, particularly for low back pain 2
- A 2010 study published in The Journal of the American Osteopathic Association, which found that OMT significantly reduces low back pain and improves functional status in patients with low back pain 3
- A 2021 study published in Complementary therapies in medicine, which found that osteopathic interventions, including OMT, are effective in reducing pain and improving functional status in patients with chronic non-specific low back pain 4
- A 2022 study published in BMJ open, which found that OMT is more effective than comparators in reducing pain and improving functional status in acute and chronic non-specific low back pain, as well as in chronic non-cancer pain and chronic non-specific neck pain 5
- A 2016 study published in The Journal of the American Osteopathic Association, which found that OMT significantly reduces pain and improves functional status in patients with nonspecific acute and chronic low back pain, including pregnant and postpartum women 6
Key Findings
Some key findings from these studies include:
- OMT is effective in reducing pain and improving functional status in patients with low back pain, with moderate-quality evidence suggesting a significant effect on pain relief and functional status 3, 4, 6
- OMT is more effective than comparators in reducing pain and improving functional status in acute and chronic non-specific low back pain, as well as in chronic non-cancer pain and chronic non-specific neck pain 5
- OMT has a significant effect on pain relief and functional status in patients with chronic non-specific low back pain, with low-quality evidence suggesting a significant difference in favor of OMT regarding pain and functional status 4
- OMT is effective in reducing pain and improving functional status in pregnant and postpartum women with low back pain, with moderate-quality evidence suggesting a significant difference in favor of OMT regarding pain and functional status 6
Conditions Treated with OMT
OMT has been used to treat a variety of conditions, including: