Author: Gerritse Marco, DO-MRO, BSc. Ost. Med. & Vander Mast Hans, DO-MROB, BSc. Ost. Med.
Supervisor: Masselus Tom, DO-MROB, MSc (University of Applied Sciences)
Introduction: Despite high incidence and prevalence numbers of non-specific neck pain, the evidence of the effect of osteopathic manipulative treatment (OMT) on non-specific neck pain is scarce. Available literature on this subject advises controlled trials with long term follow-up. Current research in manual therapy provides for evidence concerning spinal manipulation combined with supervised exercise as a successful treatment for non-specific neck pain. Nevertheless, spinal manipulation is used in different disciplines and terminology is often mingled so that results of these studies are generalized for multiple manual disciplines instead of one therapy on its own.
Objective: To investigate whether OMT is effective for treating non-specific neck pain and if this treatment is superior to general practitioner treatment which is, at present day, used as the golden standard treatment.
Study design: In a reality based black box setting three GPs recruited 22 patients and randomized the subjects in two groups: an experimental group: Exp-MD (n=13) who received a maximum of five OMT-sessions in eight weeks and a control group (n=9) who received the GP treatment. A third experimental group (Exp-OMT) of 21 patients also received a maximum of five OMT-sessions without referral of a GP. Subjects in this group were not randomized. Outcome measurements were the NDI, NRS and GPE and patients were followed up through an online questionnaire at two, four and eight weeks post baseline measurement.
Results and discussion: Except for BMI and baseline NDI, no significant differences in the baseline measurements were observed. BMI was significantly higher in both experimental groups, baseline NDI was significantly higher in the experimental group without referral. These differences were probably due to the small sample size in the control group. NDI and NRS scores decreased significantly in all three groups from baseline to eight weeks. During the treatment period (from two - four - eight weeks) only the experimental groups decreased significantly in NDI and only the Exp-OMT group in NRS. Success rates for the GPE were similar in all three groups and scored over 80% perceived recovery at eight weeks post baseline measurement. When comparing intergroup differences in treatment effect, no significant differences could be observed.
Conclusion: Within the limitations of this pilot-study, it can be stated that OMT has beneficial short- and mid-term effects on non-specific neck pain. There is a trend towards superiority of OMT versus standard GP treatment, although this superiority is not significant. For future research, sample sizes for reaching significant differences between study groups are provided in this study.
Keywords: OMT, non-specific neck pain, treatment effect, black box, GP treatment, comparison