Low Back Pain and Sciatica and Osteopathic Manipulation

Osteopathic manipulation (OM) is a form of treatment related to chiropractic manipulation, but it tends to use gentle, extended movements (low velocity, high amplitude) rather than the quick, short, cracking movements of chiropractic.

Osteopathic Manipulation has shown some promise for the treatment of sciatica and general low back pain. ^15,20,40 Osteopathic manipulation corrects structural misalignment in the back, which should alleviate much if not all of the low back pain and/or sciatica (assuming the cause of the pain was structural in nature.)

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However, one of the best-designed trials failed to find it a superior alternative to conventional medical care. In this 12-week study of 178 individuals, osteopathic manipulation proved no more effective than standard treatment for back pain.⁴⁰ Another study failed to find OM more effective than sham manipulation.⁵⁵

However, many studies do not follow patients through many treatments, nor do they allow for the treatment protocol to be individualized depending on the individual's specific low back pain or sciatica needs. For the future, research may need to move away from the "double-blind" and "placebo-controlled" structure to allow for the tailored and individualized treatment plans necessary for the effective use of osteopathic manipulation and osteopathic medicine.

Safety of Osteopathic Manipulation

Most forms of OM, because of their gentle nature, are believed to be quite safe. However, mild short-term pain may occur immediately following treatment. ¹ In addition, some osteopathic practitioners use the high-velocity thrusts common to chiropractic and might, therefore, incur some slight safety risks. (See the Chiropractic article for more information.)

1. Knebl JA, Shores JH, Gamber RG, Gray WT, Herron KM. Improving functional ability in the elderly via the Spencer technique, an osteopathic manipulative treatment: a randomized, controlled trial. J Am Osteopath Assoc. 102(7):387-96.

15. Koes BW, Assendelft WJ, van der Heijden GJ, et al. Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials. Spine. 1996;21:2860-2873.

20. Newswanger DL, Patel AT, Ogle A. Osteopathic medicine in the treatment of low back pain. Am Fam Physician. 2000;62:2414-2415.

40. Andersson GB, Lucente T, Davis AM, et al. A comparison of osteopathic spinal manipulation with standard care for patients with low back pain. N Engl J Med. 1999;341:1426-1431.

55. Licciardone JC, Stoll ST, Fulda KG, et al. Osteopathic manipulative treatment for chronic low back pain: a randomized controlled trial. Spine. 2003;28:1355-1362.