Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial

Abstract

Objective: To study osteopathic manipulative treatment (OMT) of back pain and related symptoms during the third trimester of pregnancy. Study design:A randomized, placebo-controlled trial was conducted to compare usual obstetrical care (UOBC) and OMT (UOBC+OMT), UOBC and sham ultrasound treatment (UOBC+SUT), and UOBC only. Outcomes included average pain levels and the Roland Morris-Disability Questionnaire (RMDQ) to assess back-specific functioning.Results: Intention-to-treat analyses included 144 subjects. The RMDQ scores worsened during pregnancy; however, back-specific functioning deteriorated significantly less in the UOBC+OMT group (effect size, 0.72; 95% CI, 0.31-1.14; P=.001 vs. UOBC only; and effect size, 0.35; 95% CI, −0.06-0.76; P=.09 vs. UOBC+SUT). During pregnancy, back pain decreased in the UOBC+OMT group, remained unchanged in the UOBC+SUT group, and increased in the UOBC only group, although no between-group difference achieved statistical significance. Conclusion:Osteopathic manipulative treatment slows or halts the deterioration of back-specific functioning during the third trimester of pregnancy.

Effects of craniosacral therapy as experienced by pregnant women with severe pelvic girdle pain: An interview study

“…Moreover, results confirmed descriptions of awareness of diminishing pain (pain VAS), and that they were significantly more satisfied with treatment than those only receiving ST [10] . Results also support previously reported treatment effects of CST in pregnancy-related back pain [41] , and research showing that lightly touching the skin [36] can elicit physiological responses [53] .…”

“…This qualitative descriptive [41] study was conducted in western Sweden between May 2009 and June 2010. It was part of a project encompassing an RCT comparing CST plus ST with ST alone for well-defined PGP [10] .…”

“…The women were treated with a manual release technique of the pelvis in the supine position. The therapist attempted release of tension in the fascia, ligaments and muscles using L5-S1 release, sacroiliac release, superior and inferior pubis symphysis release [41] , i.e. a standardized functional therapy assumed effective for PGP during pregnancy.…”

“…This form of treatment is used by a wide variety of health care practitioners, such as chiropractors, physical therapists, physicians, and massage therapists [31] . It is applicable in different clinical settings for both adults and children [37] , and has shown pain relieving effects and improvement of health-related quality of life in patients with fibromyalgia [38] , migraine [39] , asthma [40] and pregnancy-related low back pain [41] . It has recently been shown that according to a blinded examiner, a statistically significant number of pregnant women 11/51 (20%) receiving CST as an adjunct to standard treatment (ST) for PGP became symptom-free (no positive pain provocation tests, no markings on pain drawings, no history of diminished endurance capacity for standing, walking or sitting) and no pain (visual analogue scale =≤10 mm) compared to 2/56 (4%) of women who received ST alone [10] .…”

Low Back Pain in Pregnancy: Investigations, Management, and Role of Neuraxial Analgesia and Anaesthesia: A Systematic Review

“…Most studies adequately stated the methods used for randomization and allocation concealment barring 4 RCTs [22][23][24][25] . Blinding of participants and personnel was considered "unclear" in most studies barring "low risk" in only one study [26] and high risk in 3 other studies [27][28][29] . The blinding of outcome assessors was judged "unclear risk" in 17 studies and "low risk" in 12 studies [26][27][28][29][30][31][32][33][34][35][36] .…”