An overview of systematic reviews on the efficacy and safety of osteopathic techniques

Abstract

Objective: To investigate the efficacy and safety of manipulative osteopathic techniques in persons of all ages with various medical indications.

Design: Overview of systematic reviews and meta-analyses.

Method: We conducted a systematic literature search for systematic reviews of randomized controlled trials in English or German that compared osteopathic interventions to no treatment, sham treatment or any other non-osteopathic treatment, in bibliographic databases and other sources.

Results: We included 27 systematic reviews covering nine therapeutic indications. Based on moderate quality of evidence, osteopathic treatment was an effective means of reducing pain and partially improving physical function in adults with acute neck pain, chronic non-specific low back pain, low back pain in pregnancy, and chronic non-oncologic pain. It can also shorten the length of hospital stays in premature infants. Furthermore, osteopathic treatment may relieve symptoms in adults with chronic neck pain, postpartum low back pain, migraine, and irritable bowel syndrome, and it may help children with otitis media. It did not appear to provide relief to adults with acute non-specific low back pain, fibromyalgia, headaches of various causes, women with lower urinary tract symptoms, and children with cerebral palsy. Evidence for other indications like vertigo, chronic obstructive pulmonary disease, hypertension, gynecological or birth-related complaints, and a number of pediatric indications was insufficient to draw firm conclusions.

Conclusion: Manipulative osteopathic techniques appears to be particularly effective in musculoskeletal conditions. Overall, the evidence base for the outcomes of manual osteopathic treatment has improved, despite heterogeneous studies that are partly of poor methodological quality.

Keywords: Adverse events; Effectiveness; Evidence-based therapy; Osteopathic manipulative treatment (OMT); Osteopathic medicine; Systematic review.