L’ostéopathie prévient la lombalgie chronique

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A clinical trial evaluates the effectiveness of osteopathy on the prevention of chronic back pain in people at risk.

A randomized controlled trial of English Williams and colleagues, published in the journal Family Practice in 2003, evaluates the effectiveness of osteopathy to reduce acute and subacute back pain over a period of two months. The results show that care osteopathic improves physical health in the short term and long term mental health compared to conventional care. Additional costs osteopathy sessions are 88 euros.

The Study Rationale

Back pain, medically known as the back pain is very common in the general population. It can cause short-term repeated work stoppages, and a long, chronic illness and disability work. In 1993, back pain have been the source of a loss of 150 million working days in England.

Back pain is one of the main reasons for consulting a physician or osteopath. Each year, 843 of 10,000 visits to the doctor are for back pain.

The American and British authorities recommend using osteopathy prevention to help patients better manage their acute low back pain and subacute. They also recommend the use of this non-pharmacological intervention in the prevention of chronic low back pain. Osteopathy could be profitable for primary health services.

The Question

Is a primary care osteopathy effective in relieving acute and subacute back pain?

The Method

The randomized controlled trial of Williams and colleagues evaluated the benefits of osteopathy on mental and physical health of patients with acute and subacute spinal pain. The study examined 201 people aged between 16 and 65 years. They had consulted their GP for pain in the neck or back appeared between 2-12 weeks before. Their pain could be a recurrence of a first episode.

All patients in the trial continued to receive their usual treatment such as tips on rest on the daily activities and work, and if necessary a prescription of analgesics and nonsteroidal anti-inflammatory and guidance to secondary treatment (eg physiotherapy).

The feedback between the osteopathy group and controlled in routine care were carried out before the start of the intervention, the end of surgery (two months) and 6 months.

The measures concerned health status related to spinal pain (Extended Aberdeen Spine Pain Scale Questionnaire – EASPS), the quality of physical and mental life (SF-12 Questionnaire), sensory and affective dimensions of pain (Short-form questionnaires McGill Pain Questionnaire – SMPQ), cost-effectiveness and cost-utility (EQ-5D).

The Non-Pharmacological Intervention (NPI) assessed

The NPI was performed in an osteopathic clinic in the UK. The participants attended 3-4 sessions performed by a doctor trained in osteopathy. The sessions were spaced one to two weeks in a maximum time interval of two months. The program included a spinal osteopathic manipulation, and advice on regular physical activity. If symptoms persist, injections of anti-inflammatory products were performed in the peripheral joints or ligaments.

Main Results

The results show the end of two months osteopathic intervention reduced the intensity of back pain and an improvement in the mental component of quality of life compared to the control group. The mental component of quality of life is superior to the control group after six months. By cons, pain levels become equal between the groups after six months.

The costs of specific health care to spinal pain were significantly higher in the group receiving the intervention in osteopathy. They amount to 88 euros per patient.

What it means for Patients

Three to four sessions of osteopathy in two months carried out in addition to standard care reduced sore back in the short term and improve the long-term morale. Additional expenses totaled 88 euros.

What it means for Healthcare Professionals

An early treatment of acute or subacute back pain by a trained doctor of osteopathy improves mental component of quality of life in the medium term and the intensity of the short-term pain. A better understanding of pain and psychological distress can explain this benefit. Psychosocial factors have an important role in the development of disability and transition subacute pain to chronic pain.

What it means for Researchers

This randomized controlled trial proves the effectiveness of osteopathy on physical health in the short term and long term mental health. Multicentre studies based on rigorous scientific method and homogeneous osteopathic practice between the sites are now required to verify the effectiveness and the cost / effectiveness of this type of non-drug intervention.

What it means for Policymakers

Osteopathy is increasingly used in secondary prevention and therapy. This study shows the benefits of osteopathy intervention on mental and physical health. The cost assigned to the support is greater than a usual support 88 euros per patient, but with a significant benefit on the health and quality of life.

The Reference

Williams NH, Wilkinson C, Russel I, Edwards RT, Hibbs R, Linck P, Muntz R (2003). Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care. Family Practice, 20 (6), 662-629.

Related articles on Blog en Sante ©

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Same population

Same non-pharmacological intervention

To reference this Blog en Sante © article

Ninot G (2015). Osteopathy prevents chronic back pain. Blog en Sante, A67.

© Copyright 2015 Gregory Ninot. All rights reserved.