PM R. 2021 Oct 31. doi: 10.1002/pmrj.12732. Online ahead of print.
ABSTRACT
BACKGROUND: Neck pain (NP) affects as much as 70% of individuals at some point in their lives. Systematic reviews indicate that manual treatments can be moderately effective in the management of chronic, nonspecific NP. However, there is a paucity of studies specifically evaluating the efficacy of osteopathic manipulative treatment (OMT).
OBJECTIVE: To evaluate the efficacy of OMT in reducing pain and disability in patients with chronic NP.
DESIGN: Single-blinded, cross-over, randomized controlled trial.
SETTING: University-based, osteopathic manipulative medicine outpatient clinic.
PARTICIPANTS: 97 participants, 21-65 years old, with chronic, nonspecific NP.
INTERVENTIONS: Participants were randomized to two trial arms: immediate OMT intervention or waiting period first. The intervention consisted of 3-4 OMT sessions over 4-6 weeks, after which the participants switched groups.
MAIN OUTCOME MEASURES: Primary outcome measures were pain intensity (average and current) on the numerical rating scale and Neck Disability Index. Secondary outcomes included PROMIS-29 health domains and Fear Avoidance Beliefs Questionnaire. Outcomes obtained prior to the cross-over allocation were evaluated using general linear models and after adjusting for baseline values.
RESULTS: 38 and 37 participants were available for the analysis in the OMT and waiting period groups, respectively. The results showed significantly better primary outcomes in the immediate OMT group for reductions in average pain (-1.02, 95%CI:[-1.72, -0.32], P = 0.005), current pain (-1.02, 95%CI:[-1.75, -0.30], P = 0.006), disability (-5.30%, 95%CI:[-9.2%, -1.3%], P = 0.010) and improved secondary outcomes (PROMIS) related to sleep (-3.25, 95%CI: [-6.95, -1.54], P = 0.003), fatigue (-3.26, 95%CI:[-6.04, -0.48], P = 0.022), and depression (-2.59, 95%CI:[-4.73, -0.45], P = 0.018). The effect sizes were in the clinically meaningful range between 0.5 and 1 SD. No study-related serious adverse events were reported.
CONCLUSIONS: OMT is relatively safe and effective in reducing pain and disability along with improving sleep, fatigue, and depression in patients with chronic NP immediately following treatment delivered over approximately 4-6 weeks.
TRIAL REGISTRATION: ClinicalTrials.gov NCT# 02261259. This article is protected by copyright. All rights reserved.
PMID:34719122 | DOI:10.1002/pmrj.12732
