Arthritis News – 1999

Millions of patients with back pain seek manual therapy involving spinal manipulation in addition to, or as an alternative to, conventional treatment that includes physical therapy, surgery and medications. In contrast to the chiropractic approach that focuses on the nervous system and advocates adjustments to the spinal vertebrae, osteopathic medicine utilizes manual therapy in combination with standard treatment methods, and focuses on the need to optimize blood circulation to maintain and restore health. Leurgans, etal (N Engl J Med 341:1426, 1999) compared standard care to osteopathic care in 155 patients who had had low back pain for at least three weeks but less than six months in a randomized, controlled trial.

Outcomes of treatment were assessed over a 12-week period using the Roland-Morris and Oswestry questionnaires, a visual-analogue pain scale, and measurements of range of motion and straight-leg raising. Greater than 90% of patients in both groups expressed satisfaction with their method of care and changes in the primary outcomes did not differ significantly. However, the use of medications, including nonsteroidal antiinflamatory drugs (NSAIDs) and muscle relaxants, was significantly higher (p<0.001) in the standard care group (n=72) when compared to the osteopathic treatment group (n=83). Additionally, the standard care group utilized physical therapy more frequently than the osteopathic care group (2.6% vs. 0.2%, p<0.05).

These data suggest, that while both standard care and osteopathic care are equally effective when comparing clinical outcomes of pain relief and function, patients receiving osteopathic care use less medication and physical therapy reducing both costs to the patients and potentially serious side effects from the use of NSAIDs.