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Osteopathic Manipulation of Questionable Benefit for Low Back Pain

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NEJM Journal Watch

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Osteopathic manipulative treatment had a statistically significant but small effect on low back pain in a randomized trial in JAMA Internal Medicine. The researchers question the clinical usefulness of the treatment.

Some 400 people in France with nonspecific subacute or chronic low back pain were assigned to receive either standard or sham osteopathic manipulative treatment. All patients received six 45-minute sessions 2 weeks apart. Sham treatment consisted of light touch.

After 3 months, the treatment group had a larger reduction in a score measuring low back pain-specific activity limitations (4.7-point reduction vs. 1.3 for the sham group, on a 100-point scale). However, a 20-point change was considered the minimal important change. In addition, the two groups did not differ in pain reduction, use of analgesics or nonsteroidal anti-inflammatory drugs, health-related quality of life, or work absences.

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