Osteopathy: effectiveness and safety for musculoskeletal pain – a systematic review

Introduction Osteopathy aims to holistically improve and support all health aspects. Mainly patients with musculoskeletal pain are treated. Worldwide, osteopathy has no consistent regulation/education/practice standards. This review summarises the evidence on the effectiveness and safety of osteopathy in treating musculoskeletal pain.

Methods A systematic literature search for RCTs was conducted. From 964 identified citations, the best available evidence (n=15) for each body region was selected according to the Cochrane Collaboration’s tool. Additionally, we summarised a recent meta-analysis for chronic low-back pain, which we critically appraised (AMSTAR 2).

Results Statistically significant and some clinically meaningful reductions in pain up to three months in favour of osteopathy were observed for neck pain. For chronic low back pain, osteopathy improved pain for up to three months. It seems that shoulder and foot pain can possibly be reduced by osteopathy. We cannot make a final statement for knee pain, osteoporosis, and fibromyalgia. No statistically/clinically significant deteriorations occurred. Osteopathy represents a safe therapeutic choice, as only very few patients reported minor adverse events.

Conclusion The risk of bias was unclear to high. Serious limitations were given due to a lack of blinding, which the nature of osteopathy does hardly allow. The included meta-analysis was rated with high overall confidence. Variations of techniques were observed even inside the same typology of intervention. Osteopathy can improve neck and low back pain in the short- and mid-term. Regulations regarding education/practice/training are needed before reimbursement. It is essential to orientate on international standards and adapt those for each country.

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Artikel online veröffentlicht:
09. Oktober 2023