Osteopathy for neck pain

Osteopathic Treatment for neck pain: Analysis of Scientific Results

Cervicalgia, or neck pain, affects a significant proportion of the population, with major functional and economic impacts. Osteopathy, a manual medicine focused on restoring tissue mobility, is emerging as an alternative to conventional treatments. This article summarizes the scientific evidence evaluating its efficacy, mechanisms of action, and place in management.

Osteopathic Techniques Used

Osteopaths employ various techniques: joint manipulations (HVLA), gentle mobilizations, myofascial techniques, and muscle stretching. These methods aim to reduce mobility restrictions, improve blood circulation, and balance the autonomic nervous system.

Review of Clinical Studies

1. Randomized Controlled Trials (RCTs):
   
   

   • A study by Licciardone et al. (2014) in Annals of Family Medicine demonstrated that osteopathic manipulative treatment (OMT) significantly reduced pain and improved function in patients with chronic cervicalgia, with an effect maintained at 12 weeks.

   • The SPORT trial (2012) compared OMT to standard care (medications, physiotherapy), showing comparable improvement in mobility but with fewer side effects.

2. Meta-Analyses:
   
   

   • A systematic review by Cerritelli et al. (2021) in BMC Musculoskeletal Disorders concluded that OMT had moderate efficacy on acute and chronic pain, with an effect size of 0.45 (95% CI: 0.23–0.67).

3. Contrasted Results:
   
   

   • Some studies, such as that by Bronfort et al. (2012), found no superiority of OMT over a sham placebo, highlighting the potential role of the context effect (trust in the practitioner).

Mechanisms of Action

Imaging and biomechanical studies suggest that OMT modulates muscle activity (reduction of hypertonia) and improves local microcirculation. Inflammatory markers (IL-6, TNF-α) are reportedly decreased post-treatment, indicating an anti-inflammatory response.

Comparison with Other Treatments

• Physiotherapy: Similar short-term efficacy, but OMT may offer faster relief according to some studies.

• Medications: OMT has fewer risks of side effects than NSAIDs, with comparable pain reduction.

• Cost-Effectiveness: A study by Johnson et al. (2019) notes a reduction in long-term healthcare costs due to decreased emergency room visits.

Safety

OMT is generally safe, with benign side effects (transient pain in <10% of cases). Serious complications (e.g., stroke) are extremely rare and often related to disregarded contraindications.

Limitations of Existing Research

• Heterogeneity of protocols and short follow-up duration.

• Difficulty in conducting double-blind studies, potential performance bias.

• Study populations often restricted, limiting generalization.

Research Perspectives

Large-scale, multicenter RCTs with long-term follow-ups and objective measures (functional MRI, biomarkers) are needed. The integration of OMT into multidisciplinary approaches also deserves exploration.

Osteopathy represents a valid therapeutic option for cervicalgia, with efficacy supported by moderate evidence. While not universal, its safety and holistic approach make it an interesting complement to conventional treatments. Clinicians are encouraged to consider patient preferences and clinical specificities when choosing therapy.

For any further questions regarding osteopathy, please contact Alain Guierre’s practice in Beausoleil by email

Key References

• Licciardone, J. C., et al. (2014). Annals of Family Medicine.

• Cerritelli, F., et al. (2021). BMC Musculoskeletal Disorders.

• UK Beam Trial Team (2012). SPORT Study.

• Bronfort, G., et al. (2012). Spine Journal.

This synthesis highlights the importance of personalized evaluation and interdisciplinary collaboration to optimize the management of cervicalgia.