Recently, an interesting single-blinded, sham-controlled randomized clinical trial was published in JAMA Internal Medicine by Nguyen et al. (2021). Therein, patients with nonspecific subacute or chronic low back pain (LBP) were treated with either standard osteopathic manipulative treatment (OMT) or sham OMT (light touch applied according to standardized protocol) to compare the efficacy for reducing LBP-specific activity limitations. Participants from both groups underwent six 45-minute sessions once every two weeks. Outcomes included mean changes for LBP-specific activity limitations, pain, health-related quality of life, and intake of analgesics and nonsteroidal anti-inflammatory drugs at 3 and 12 months. Further, the number and duration of sick leaves and LBP episodes (days) were measured at 12 months, and self-reported adverse events were assessed at 3, 6, and 12 months. 400 participants were randomized (197 in both groups after dropouts) and mean changes in LBP-specific activity limitations were reported with −4.7 (3 months) and −5.6 (12 months) for standard OMT and −1.3 (3 and 12 months) for sham OMT, respectively. Besides this small effect (favoring standard OMT), no difference between standard and sham OMT was reported for pain, health-related quality of life, medication consumption, sick leaves, and LBP episodes; however, adverse events were also not related to OMT. According to the authors, these effects are not clinically meaningful and scrutinize the usefulness of OMT for patients with nonspecific subacute and chronic LBP.
Nguyen, C., Boutron, I., Zegarra-Parodi, R., Baron, G., Alami, S., Sanchez, K., Daste, C., Boisson, M., Fabre, L., Krief, P., Krief, G., Lefèvre-Colau, M.-M., Rannou, F., 2021. Effect of Osteopathic Manipulative Treatment vs Sham Treatment on Activity Limitations in Patients With Nonspecific Subacute and Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Internal Medicine, e210005. doi:10.1001/jamainternmed.2021.0005.