Neck pain and osteopathic treatment
Paper: Franke et al, 2015, Osteopathic manipulative treatment for chronic nonspecific neck pain: A systematic review and meta-analysis, IJOM, vol 18:4, pp 255-267, accessed 24/01/16 via www.osteopathy.org.uk
Neck pain occurs in all ages of the population and 30-50% of adults are thought to suffer in any twelve month period. It is the second most common problem that someone might visit an osteopath for, however most of the research regarding treatment for neck pain is technique specific, rather than discipline (osteopathy, physiotherapy etc) specific.
This paper provides structured analysis of Randomised Controlled Trials (RCTs), which themselves are considered the gold standard of clinical trials. It looks at the effects of osteopathic manipulative treatment (OMT) on chronic nonspecific neck pain – that is ongoing neck pain that started for no apparent reason. Pain and function are analysed, in addition to the reporting of any adverse events. Systematic reviews of osteopathic treatment for neck pain seem to be lacking and meta-analyses such as these provide data guidelines for best care.
Careful attention was paid to the data collection process and reliable tools were used to assess and grade the data (for example methodological quality was assessed using Risk of Bias assessment tool from Cochrane Back Review Group.22.).
Results: Of 299 studies found only 3 studies were relevant and comparable which limits the research findings and to some extent downgrades the evidence produced. However, findings do suggest that OMT helped reduce patient reported pain by a clinically significant magnitude. Functional status did not respond so favourably but similar low back pain studies also show greater effects on pain than functional status. The specific of types of osteopathic treatment for neck pain were not standardised, leaving the osteopath able to choose patient-specific approaches, as would be the case in the clinical setting, such as functional, mobilisation or cranial treatment.
One Cochrane review was also supportive of thoracic spine manipulation for pain relief and function and additional exercise was thought to be beneficial to neck pain sufferers.
This paper is welcomed by the osteopathic profession as further evidence of treatment efficacy. The findings can be shared with patients when discussing treatment options and practitioners can confidently proceed with OMT for chronic non-specific neck pain.