Effects of an osteopathic clinical based approach for the treatment of chronic non-specific low back pain in factory workers: A single cohort, pilot study

Abstract

Background: Chronic Non specific Low Back Pain (NSLBP) is a large economic burden to the healthcare systems of western industrialized countries. Although studies have demonstrated the efficacy of spinal manipulative therapy for NSLBP, few studies have adopted a pragmatic approach using a wide range of techniques that would typically be employed in a clinical setting.

Design: A homogenous sample of twenty, predominantly Maori and Pacific Islands factory workers gave informed consent. The participants took part in a single cohort pre/post repeated measures intervention over nine weeks.

Outcome Measures: Visual Analogue Scale (VAS), Quebec Back Pain Functional Disability Score (QBPDS), and short form 12 (SF12), completed at baseline, pre and post treatment, and one week follow up.

Methods: Baseline subjective measures were recorded over five weeks. Three pragmatic-based osteopathic treatments, tailored to each participant, were administered once per week.

Results: Intention to treat analysis of fifteen participants (67% male and 33% female, mean age 43.6 years), with a mean duration of chronic NSLBP of 6.6 years, showed a clinically relevant 20.1mm reduction in LBP intensity on VAS (95% CI = 8.5 to 18.1; p<0.0001). A 15.1 points fall in physical disability on QBPDS (95% CI = 6.29 to 16.1; p<0.001), and a 6 point increase in SF12 physical ability (95% CI = 45.3 to 52.5; p<0.004) were also clinically relevant. No substantial changes were found in mental health scores as measured by SF12 (p=0.323).

Conclusion: Application of manual therapy techniques using a pragmatic osteopathic approach demonstrated a clinically relevant reduction in LBP intensity and physical disability in a population of Maori and Pacific Islands factory workers with chronic NSLBP.