Osteopathic Manipulative Therapy: An Effective Alternative to Common Pharmacological Treatments for Low Back Pain

Author

Nicole Shirman, Lynn University

Date of Award

7-2024

Document Type

Capstone

Granting Institution

Lynn University

Degree Name

Master of Science (MS)

Degree Program

Biological Science

Department

College of Arts and Sciences

First Advisor

Dr. Jonathan Smith

Abstract

Osteopathic manipulative therapy (OMT) is a promising non-pharmacological treatment for low back pain, but its efficacy and mechanisms have been debated. This literature review provides a comprehensive assessment of OMT’s therapeutic effects and potential mechanisms for the treatment of low back pain. Multiple randomized trials demonstrate OMT provides statistically and clinically meaningful reductions in pain intensity and disability compared to sham treatments or standard care, particularly among patients with higher baseline symptom severity. Subgroup analyses reveal older age and absence of depression enhance OMT response rates. OMT appears safe and well-tolerated, with high patient satisfaction and reduced analgesic requirements versus controls. Mechanistic studies suggest OMT may mitigate biomechanical dysfunctions, exert anti-inflammatory effects via cytokine modulation, and stimulate immunomodulatory processes. While OMT displays general efficacy, developing predictive models to optimize patient selection is a key priority in expanding its utilization. Given its benefits and non-pharmacological profile, OMT is a valuable potential tool for combating the opioid epidemic through first-line pain management. However, further research directly comparing OMT to opioids and evaluating opioid-sparing impacts is needed. Overall, this review positions OMT as an effective conservative therapy for chronic low back pain before escalating care, with a compelling role in fighting public health crises like opioid abuse as a non-invasive and non-addictive manual therapy. Strategic implementation of evidence-based OMT protocols may enhance patients’ quality of life while concurrently mitigating the socioeconomic burden of low back pain.

Recommended Citation

Shirman, N. (2024). Osteopathic manipulative therapy: An effective alternative to common pharmacological treatments for low back pain [Masters capstone, Lynn University]. SPIRAL. https://spiral.lynn.edu/etds/422