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Clinical Trial
. 2010 Jan;202(1):43.e1-8.
doi: 10.1016/j.ajog.2009.07.057. Epub 2009 Sep 20.

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

John C Licciardone  1 , Steve Buchanan, Kendi L Hensel, Hollis H King, Kimberly G Fulda, Scott T Stoll
Affiliations
Clinical Trial

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

John C Licciardone et al. Am J Obstet Gynecol. 2010 Jan.

Abstract

Objective: To study osteopathic manipulative treatment of back pain and related symptoms during the third trimester of pregnancy.

Study design: A randomized, placebo-controlled trial was conducted to compare usual obstetric care and osteopathic manipulative treatment, usual obstetric care and sham ultrasound treatment, and usual obstetric care only. Outcomes included average pain levels and the Roland-Morris Disability Questionnaire to assess back-specific functioning.

Results: Intention-to-treat analyses included 144 subjects. The Roland-Morris Disability Questionnaire scores worsened during pregnancy; however, back-specific functioning deteriorated significantly less in the usual obstetric care and osteopathic manipulative treatment group (effect size, 0.72; 95% confidence interval, 0.31-1.14; P = .001 vs usual obstetric care only; and effect size, 0.35; 95% confidence interval, -0.06 to 0.76; P = .09 vs usual obstetric care and sham ultrasound treatment). During pregnancy, back pain decreased in the usual obstetric care and osteopathic manipulative treatment group, remained unchanged in the usual obstetric care and sham ultrasound treatment group, and increased in the usual obstetric care 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.

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Figures

Figure 1
Figure 1. Flow of subjects through the trial
OMT denotes osteopathic manipulative treatment; SUT, sham ultrasound treatment; UOBC, usual obstetrical care.
Figure 2
Figure 2. Distribution of completed visits over time
Statistically significant differences among treatment groups were observed at visits 2, 3, 4, 6, and 7. Observations at a given visit that do not have a letter in common are significantly different than one another (e.g., “a” and “b” are significantly different, but “ab” is not significantly different than “a” or “b”).
Figure 3
Figure 3. Average back pain levels over time
OMT denotes osteopathic manipulative treatment; SUT, sham ultrasound treatment; UOBC, usual obstetrical care. Results are presented as mean + standard error. There were no statistically significant differences in pain levels among treatment groups.
Figure 4
Figure 4. Roland-Morris Disability Questionnaire (RMDQ) scores over time
OMT denotes osteopathic manipulative treatment; SUT, sham ultrasound treatment; UOBC, usual obstetrical care. Results are presented as mean + standard error. The treatment group (P=.02) and time (P=.01) main effects and the treatment group X time interaction effect (P<.001) were all statistically significant.
Figure 5
Figure 5. Graphical summary of treatment effects
MIB denotes minimally important benefit; MIH, minimally important harm; OMT, osteopathic manipulative treatment; SUT, sham ultrasound treatment; UOBC, usual obstetrical care. Results are presented as effect size and 95% confidence interval. Positive and negative effect sizes represent benefits and harms, respectively.
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References

    1. Fast A, Shapiro D, Ducommun EJ, Friedmann LW, Bouklas T, Floman Y. Low-back pain in pregnancy. Spine. 1987;12:368–71. - PubMed
    1. To WW, Wong MW. Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy. Acta Obstet Gynecol Scand. 2003;82:1086–91. - PubMed
    1. Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-Andrews AA, Kain ZN. Low back pain during pregnancy: prevalence, risk factors, and outcomes. Obstet Gynecol. 2004;104:65–70. - PubMed
    1. Skaggs CD, Prather H, Gross G, George JW, Thompson PA, Nelson DM. Back and pelvic pain in an underserved United States pregnant population: a preliminary descriptive survey. J Manipulative Physiol Ther. 2007;30:130–4. - PubMed
    1. Ritchie JR. Orthopedic considerations during pregnancy. Clin Obstet Gynecol. 2003;46:456–66. - PubMed

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