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The effect of osteopathic treatment on people with chronic and sub-chronic neck pain: A pilot study

      Abstract

      Background and objectives

      Neck pain is a common problem in the general population and can be severely disabling and costly for the individual. The aim of this single cohort pilot study was to investigate if osteopathic treatment would reduce perceived pain and disability in people with neck pain.

      Methods

      Seventeen subjects (mean age 34.8 [SD=11.9] years, 7 males, 10 females) with neck pain (mean duration of symptoms of 168.8 weeks [SD=292, range=4–1040]) were recruited and included in this study. The subjects were offered a 4-week course of osteopathic treatment at a university teaching clinic. McGill pain questionnaires (MPQ), visual analogue scales (VAS), and neck disability index (NDI) were completed prior to the initial treatment and after treatments on weeks 2 and 4.

      Results

      Analysis with repeated measures ANOVA revealed statistically significant differences between pre- and post-scores for the MPQ (F2,32=17.35, P=0.001), VAS (F1.62,25.92=36.01, P<0.001) and NDI (F2,32=14.63, P<0.001). Pre/post effect sizes were large for MPQ (d=1.28), VAS (d=1.57) and NDI (d=1.12) scores. Further testing using paired t-tests revealed these differences to be significant between all time periods for the MPQ, and between the pre-treatment and 2-week period and pre-treatment and 4-week period for the VAS and NDI, respectively. When the cohort was subdivided into a sub-chronic (symptom duration less than 52 weeks) and chronic group (symptoms longer than 52 weeks), similar significant differences were found in both groups.

      Conclusion

      Self-rated pain and disability significantly reduced during the course of osteopathic treatment, and reductions were evident regardless of the chronicity of the pain. This pilot study suggests that osteopathic treatment may be effective for the management of neck pain. Recommendations are made for further studies.

      Keywords

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      References

        • Cote P.
        • Cassidy J.D.
        • Carroll L.
        The Saskatchewan health and back pain survey: the prevalence of neck pain and related disability in Saskatchewan adults.
        Spine. 1998; 23: 1689-1698
        • Cote P.
        • Cassidy J.D.
        • Carroll L.
        • Kristman V.
        The annual incidence and course of neck pain in the general population: a population based cohort study.
        Pain. 2004; 112: 267-273
        • Anderson H.I.
        • Ejlertsson G.
        • Leden I.
        • Rosenburg C.
        Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localisation.
        Clin J Pain. 1993; 9: 174-182
        • Merskey H.
        • Bogduk N.
        Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms.
        2nd ed. IASP Press, Seattle1994
        • Klenerman L.
        • Slade P.D.
        • Stanley I.
        • Pennie B.
        • Reily J.
        • Atchison L.
        • et al.
        The prediction of chronicity in patients with an acute attack of low back pain in a general practice.
        Spine. 1995; 20: 478-484
        • Bogduk N.
        • Yoganandan N.
        Biomechanics of the cervical spine part 3: minor injuries.
        Clin Biomech. 2001; 16: 267-275
        • Bogduk N.
        Clinical anatomy of the lumbar spine and sacrum.
        3rd ed. Churchill Livingstone, 1997
        • Curatolo M.
        • Arendt-Nielsen L.
        • Petersen-Felix S.
        Evidence, mechanisms, and clinical implications of central hypersensitivity in chronic pain after whiplash injury.
        Clin J Pain. 2004; 20: 469-476
        • Kappler R.E.
        Cervical spine.
        in: Ward R.C. Foundations for osteopathic medicine. 2nd ed. Williams & Wilkins, Baltimore2002: 685-689
        • Greenman P.E.
        Principles of manual medicine.
        2nd ed. William & Wilkins, Baltimore1996
        • Stone C.
        Science in the art of osteopathy.
        Stanley Thornes Ltd, UK1999
        • Hoving J.L.
        • Koes B.W.
        • de Vet H.C.
        • van der Windt D.A.
        • Assendelft W.J.
        • Mameren H.
        • et al.
        Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain: a randomized, controlled trial.
        Ann Intern Med. 2002; 136: 713-722
        • Jordan A.
        • Bendix T.
        • Nielsen H.
        • Hansen F.R.
        • Host D.
        • Winkel A.
        Intensive training, physiotherapy, or manipulation for patients with chronic neck pain. A prospective, single blinded, randomised clinical trial.
        Spine. 1998; 23: 311-319
        • Bronfort G.
        • Evans R.
        • Nelson B.
        • Aker P.D.
        • Goldsmith C.H.
        • Vernon H.
        A randomised clinical trial of exercise and spinal manipulation for patients with chronic neck pain.
        Spine. 2001; 26: 788-797
        • Korthals-de Bos I.B.C.
        • Hoving J.L.
        • van Tulder M.W.
        • Rutten-van Mölken M.P.M.H.
        • Adèr H.J.
        • de Vet H.C.W.
        • et al.
        Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial.
        Br Med J. 2003; 326: 911
        • Cassidy D.J.
        • Lopes A.A.
        • Yong-Hing K.
        The immediate effect of manipulation versus mobilization on pain and range of motion in the cervical spine: a randomized controlled trial.
        J Manipulative Physiol Ther. 1992; 15: 570-575
        • Pikula J.R.
        The effect of spinal manipulative therapy (SMT) on pain reduction and range of motion in patients with acute unilateral neck pain: a pilot study.
        J Can Chiropr Assoc. 1999; : 43
        • Vincenzino B.
        • Collins D.
        • Benson H.
        • Wright A.
        An investigation of the interrelationship between manipulative therapy – induced hypoalgesia and sympathoexcitation.
        J Manipulative Physiol Ther. 1998; 21: 448-453
      1. Cleland JA, Childs JD, McRae M, Palmer JA, Stowell T. Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. Man Ther, in press. doi:10.1016/j.math.2004.08.005.

        • Wall P.
        • Melzack R.
        Textbook of pain.
        4th ed. Churchill Livingstone, Edinburgh1999
        • Lorig Kate
        Outcome measures for health education and other health and other health care interventions.
        Sage Publications, Thousand Oaks1996
        • Price D.D.
        • McGrath P.A.
        • Rafii A.
        • Buckingham B.
        The validation of visual analogue scales as ratio scale measures for chronic and experimental pain.
        Pain. 1983; 17: 45-56
        • Bolton J.
        • Wilkinson R.
        Responsiveness of pain scales: a comparison of three pain intensity measures in chiropractic patients.
        J Manipulative Physiol Ther. 1998; 21: 1-7
        • Kelly A.
        The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain.
        Emerg Med J. 2001; 18: 205-207
        • Vernon H.
        • Mior S.
        The neck disability index: a study of reliability and validity.
        J Manipulative Physiol Ther. 2001; 14: 409-415
        • Gibbons P.
        • Tehan P.
        Manipulation of the spine, thorax and pelvis. An osteopathic perspective.
        Churchill Livingstone, London2000
        • Aron A.
        • Aron E.N.
        Statistics for psychology.
        2nd ed. Prentice-Hall, New Jersey1999
        • Coakes S.J.
        • Lyndall G.S.
        SPSS: analysis without anguish.
        Wiley & Sons, Australia2003
        • Speed H.D.
        • Andersen M.B.
        What exercise and sport scientists don't understand.
        J Sci Med Sport. 2000; 3: 84-92
        • Hollis S.
        • Campbell F.
        What is meant by intention to treat analysis? Survey of published randomized controlled trials.
        Br Med J. 1999; 319: 670-674
        • DiGiovanna E.L.
        • Schiowitz S.
        An osteopathic approach to diagnosis & treatment.
        2nd ed. Lippincott-Raven, Philadelphia1997