Authors: Barrix David, Bsc.(Hons.)Ost. Med. & De Cock Hugo, Bsc.(Hons.)Ost. Med.
Supervisor: De Petter Brenda, MD.
Introduction: The necessity for scientific evidence supporting the effect of osteopathy is great. The KCE report only refers to evidence for neck and lower back pain. The relative lack of related literature suggests that complaints of the thoracic spine are underestimated. This is despite an established high prevalence, significant resultant invalidity and the frequent treatment of this region by osteopaths.
Study design: In a reality based setting 45 osteopaths were recruited to treat and monitor, by way of a questionnaire, the first 5 patients presenting with non-specific thoracic pain during a study period of 3 months (n=85). The results were compared to data collected in the same way from a physiotherapy group (n=37) recruited to treat patients with the same symptoms.
Results and discussion: The osteopathic black box approach resulted in a statistically greater effect, as measured by a pain score, in this population when compared to the physiotherapy group. This was the case for the absolute pain score (a decrease of 4.3 points = 65.15% compared to a decrease of 2.3 points = 31.35%), average effect per treatment (1.5 points compared to 0.5 points) and the decreased pain score over a defined time period of 18 days ( 3.3 points = 50 % compared to 2.1 points = 28.77 %). In the subgroup of patients who had the complaint for longer than 1 month before starting the treatment only the osteopathy group showed a clinically significant decrease in pain. The difference in effect between the groups was also demonstrated in terms of decreased medication use, pain during normal movements and postures and hindering pain during daily activities.
Conclusion: This study compared the effects of osteopathy directly with those of physiotherapy. Physiotherapy is the most frequent referral destination for non–specific thoracic pain. Both osteopathy and physiotherapy result in a statistically significant improvement for this complaint. However, the treatment effects of osteopathy are significantly superior and are clinically very relevant. The nul hypotheses of this study are therefore rejected. Future study aimed at evaluating the effect of osteopathy in this population as demonstrated in this study compared to a placebo treatment is suggested.
Keywords: osteopathy, black box approach, physiotherapy, comparison, effects, non-specific thoracic pain