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DeFrancisis JS, Vinarski BM, Abreu M, Ibrahim J, Hostoffer R. Efficacy of Osteopathic Manipulative Treatment in Creating a Difference in Pain Levels for Patients With Localized Joint Pain: A Meta-Analysis of Randomized Controlled Trials. Cureus 2025; 17:e82724. [PMID: 40406764 PMCID: PMC12097846 DOI: 10.7759/cureus.82724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2025] [Accepted: 04/21/2025] [Indexed: 05/26/2025] Open
Abstract
Osteopathic manipulative treatment (OMT) is a therapy utilized by osteopathic physicians in diverse clinical environments. Among the many uses, OMT may be used in attempts to relieve pain in patients. Joint pain is among the most common causes of pain, with millions worldwide suffering from joint pain. This meta-analysis examines the efficacy of OMT in creating a difference in pain levels for patients with localized joint pain. This meta-analysis, comprising three studies and 187 patients, found a mean difference in pain between OMT and non-OMT groups using the common effects model to be -3.09 (-3.57; -2.61) with p<0.0001, suggesting that OMT resulted in a significant pain difference in those with joint pain. However, the random effects model showed a mean difference of -1.80 (-7.31; 3.78), which was not statistically significant. Furthermore, the meta-analysis at hand had a heterogeneity measure, known as I2, at 96%, suggesting that the results should be interpreted with caution. Further analysis showed that shoulder pain reduction had a significant influence on the overall study results, and sub-analysis showed that OMT can result in a significant reduction in pain in patients with localized shoulder pain, with a mean difference of -4.28 (-4.86; -3.70) and p<0.0001. Overall, given the discrepancy in results between the common effects model, random effects model, and high heterogeneity, a conclusive statement on whether OMT can cause a significant difference in joint pain cannot be made. Further research with standardized treatment lengths, larger sample sizes, and more homogeneous patient populations is needed to accurately assess the true impact.
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Affiliation(s)
- Jason S DeFrancisis
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Benjamin M Vinarski
- Internal Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Melany Abreu
- Psychiatry, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Jalal Ibrahim
- Dermatology, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Robert Hostoffer
- Allergy and Immunology, Case Western Reserve University, Cleveland, USA
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Chen IW, Liao YT, Tseng H, Lin HC, Chou LW. Pain, function and peritendinous effusion improvement after dry needling in patients with long head of biceps brachii tendinopathy: a single-blind randomized clinical trial. Ann Med 2024; 56:2391528. [PMID: 39140690 PMCID: PMC11328602 DOI: 10.1080/07853890.2024.2391528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 08/15/2024] Open
Abstract
INTRODUCTION Long head of biceps brachii tendinopathy, a frequent source of anterior shoulder pain, may lead to discomfort and diminished function. The objective of this study is to assess the efficacy of dry needling and transcutaneous electrical nerve stimulation in these patients. PATIENTS AND METHODS Thirty patients were randomized into dry needling and transcutaneous electrical nerve stimulation groups and assessed before treatment, 8 and 15 days after treatment using a visual analogue scale, shoulder pain and disability index, pressure pain threshold, tissue hardness, and biceps peritendinous effusion. RESULTS Both treatments significantly reduced the visual analogue scale in immediate (p < 0.001), short-term (p < 0.01), and medium-term effects (p < 0.01). Dry needling outperformed transcutaneous electrical nerve stimulation for the pain (p < 0.01) and disability (p < 0.03) subscales of the shoulder pain and disability index in the short-term and medium-term effects, respectively. Pressure pain threshold increased after both treatments but didn't last beyond 8 days. Neither treatment showed any improvements in tissue hardness of the long head of biceps brachii muscle. Notably, only the dry needling group significantly reduced biceps peritendinous effusion in both short-term and medium-term effects (p < 0.01). CONCLUSIONS Dry needling showed non-inferior results to transcutaneous electrical nerve stimulation in reducing pain and disability and demonstrated even superior results in reducing biceps peritendinous effusion (see Graphical Abstract). TRIAL REGISTRATION The Institutional Review Board of the China Medical University Hospital (CMUH107-REC2-101) approved this study, and it was registered with Identifier NCT03639454 on ClinicalTrials.gov.
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Affiliation(s)
- I-Wei Chen
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Ying-Tzu Liao
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Le Yang Chinese Medicine Clinic, Taipei, Taiwan
| | - Hsin Tseng
- Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
| | - Hsiao-Che Lin
- Hsiao-Che Lin Chinese Medicine Clinic, Kaohsiung, Taiwan
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
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Johnson T, Waters HB. Effects of Osteopathic Manipulative Treatment on Rare Diseases: A Case Report on Gordon Syndrome. Cureus 2024; 16:e71778. [PMID: 39559612 PMCID: PMC11570446 DOI: 10.7759/cureus.71778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 10/17/2024] [Indexed: 11/20/2024] Open
Abstract
Gordon syndrome (GS), also known as distal arthrogryposis type 3, is a rare congenital disorder characterized by debilitating multisystem defects and for which there is currently no cure. In the absence of a definitive treatment, multimodal symptomatic approaches are employed to enhance quality of life. The case presented involves a 40-year-old female with GS who exhibited multiple chronic, widespread, and severe musculoskeletal ailments that limited her daily functional capacity. This case highlights a novel application of osteopathic manipulative treatment (OMT) aimed at improving the patient's quality of life by alleviating symptoms associated with GS pathology. A personalized OMT regimen was designed to address her pain and physiological limitations resulting from a variety of somatic dysfunctions. Each appointment included a full-body treatment, with a particular focus on her most severely affected areas. Throughout the course of multiple sessions, both indirect and direct modalities were utilized with notable success. As treatment progressed, the patient reported significant improvements in functionality and reductions in pain across most body regions. While GS is rare, the positive outcomes observed in this case should serve to educate and inspire healthcare providers regarding the diverse OMT techniques available to enhance the quality of life for individuals with GS and others facing significant disease burdens.
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Affiliation(s)
- Timothy Johnson
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Holly B Waters
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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Yang F, Li X, Wang J, Gao Q, Pan M, Duan Z, Ren C, Guo P, Zhang Y. Efficacy of different analgesic strategies combined with conventional physiotherapy program for treating chronic shoulder pain: a systematic review and network meta-analysis. J Orthop Surg Res 2024; 19:544. [PMID: 39238008 PMCID: PMC11378570 DOI: 10.1186/s13018-024-05037-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 08/27/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND This study aims to investigate the efficacy of five analgesic strategies combined with conventional physiotherapy program (CPT) in managing chronic shoulder pain. METHODS Two authors independently screened studies, extracted data using a pre-formatted chart, and assessed bias using the Cochrane Risk of Bias tool. A network meta-analysis was performed by the Stata 17.0 and R 4.3.2 software. RESULTS A total of 14 studies with 862 subjects were identified. These analgesic strategies included extracorporeal shock wave therapy (ESWT), suprascapular nerve block (SSNB), corticosteroid injection (CSI), hyaluronic acid injection (HAI), and kinesio taping (KT). ESWT plus CPT was the most efficient intervention in alleviating pain intensity and improving physical function. SSNB plus CPT was the optimal intervention in improving shoulder mobility. Compared to CPT alone, CSI + CPT only significantly improved the SPADI total score, but showed no difference in pain intensity or shoulder mobility. HAI + CPT showed no significant difference in improving pain intensity, physical function, or shoulder mobility compared to CPT alone. Adding KT to CPT did not yield additional benefits in improving shoulder mobility. CONCLUSION Overall, in managing chronic shoulder pain, ESWT + CPT was the most effective intervention for reducing pain intensity and improving physical function. SSNB + CPT was optimal for enhancing shoulder mobility. Future rigorous clinical trials with larger sample sizes and higher methodological rigor are strongly required to confirm the current results.
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Affiliation(s)
- Fangjie Yang
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xinmin Li
- School of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Jing Wang
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Qian Gao
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Mengyang Pan
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Zhenfei Duan
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Chunlin Ren
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Pengxue Guo
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Yasu Zhang
- Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China.
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Ferguson J, Fritsch A, Rhon DI, Young JL. Adverse Events Reported in Trials Assessing Manual Therapy to the Extremities: A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:507-517. [PMID: 38452161 DOI: 10.1089/jicm.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Objective: This review aimed to describe the quality and comprehensiveness of adverse event (AE) reporting in clinical trials incorporating manual therapy (MT) as an intervention for extremity conditions using the Consolidated Standards of Reporting Trials (CONSORT)-Harms extension as the benchmark. The secondary aim was to determine whether the quality of AE reporting improved after the availability of the CONSORT reporting checklist. Design: Systematic review. Methods: A literature search was conducted using multiple databases to identify trials where MT was used to treat extremity conditions. Studies that reported AEs were identified and evaluated using the CONSORT-Harms extension. The frequency of trials reporting study AEs before and after the publication of the updated 2010 CONSORT statement was calculated, along with the categorization of how study AEs were reported. Results: Of the 55,539 studies initially identified, 220 trials met all inclusion criteria. Eighty trials (36.4%) reported AE occurrence. None of the studies that reported AEs adhered to all 10 criteria proposed by the 2010 CONSORT-Harms extension. The most commonly reported criterion was number four, which clarified how AE-related information was collected (30% of trials). The least reported criterion was number six, which describes the participant withdrawals for each arm due to AEs and the experience with the allocated treatment (1.3% of trials). The nomenclature used to describe AEs varied substantially. Fifty-nine of 76 trials (33.3%) were published after the updated CONSORT Harms-checklist was available, compared to 21 of 44 trials (46.7%) published before it was available. Conclusion: Reporting of AEs in trials investigating MT for extremity conditions is poor. Every included trial lacked adherence to all 10 criteria proposed by the CONSORT-Harms Extension. The quality and comprehensiveness of AE reporting did not improve after the most recent CONSORT update recommending AE reporting. Clinicians must obtain informed consent before performing any intervention, including MT, which requires disclosing potential risks, which could be better known with improved tracking, analyzing, and reporting of AEs. The authors recommend improved adherence to best practices for adequately tracking and reporting AEs in future MT trials.
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Affiliation(s)
- Jeffrey Ferguson
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Adam Fritsch
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Daniel I Rhon
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
- Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Jodi L Young
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
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Scypinski LJ, Bonitz TJ, Lomiguen CM, Chin J. Osteopathic Manipulative Treatment for a Chronic Rotator Cuff Tear: A Case Report. Cureus 2023; 15:e46292. [PMID: 37915870 PMCID: PMC10616530 DOI: 10.7759/cureus.46292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/30/2023] [Indexed: 11/03/2023] Open
Abstract
Rotator cuff tears, particularly involving the supraspinatus muscle and/or tendon, are highly prevalent among individuals engaged in repetitive shoulder motions. Occupations demanding constant and repetitive shoulder movements are especially susceptible to rotator cuff injuries, potentially leading to prolonged joint wear and tear and an increased likelihood of joint replacement. Considering the impact of social determinants of health, including access to healthcare and socioeconomic status, it is imperative to explore conservative treatment modalities that alleviate financial burdens and reduce lengthy recovery periods. In this report, we present a case of a 64-year-old female hairdresser diagnosed with a chronic partial thickness rotator cuff tear who remained unresponsive to physical therapy and chiropractic manipulation but exhibited improvement following osteopathic manipulative treatment. Additionally, osteopathic considerations and pertinent literature are reviewed to provide insight into the broader context of shoulder pain management.
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Affiliation(s)
- Luke J Scypinski
- Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Thomas J Bonitz
- Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Christine M Lomiguen
- Family Medicine, Millcreek Community Hospital, Erie, USA
- Pathology, Lake Erie College of Osteopathic Medicine, New York, USA
| | - Justin Chin
- Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA
- Family Medicine, LifeLong Medical Care, Richmond, USA
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Liu J, Hui SSC, Yang Y, Rong X, Zhang R. Effectiveness of home-based exercise for non-specific shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil 2022; 103:2036-2050. [DOI: 10.1016/j.apmr.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/02/2022] [Indexed: 12/01/2022]
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Rotter G, Binting S, Tissen-Diabaté T, Ortiz M, Brinkhaus B. Osteopathic Medicine in Four Chronic Musculoskeletal Pain Diseases: An Observational Trial with Follow-Up. Complement Med Res 2021; 29:53-66. [PMID: 34515079 DOI: 10.1159/000518311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 06/25/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIM Patients with chronic musculoskeletal pain diseases (CMPDs) often use osteopathic medicine (OM), although the changes in patients with pain diseases are still insufficiently investigated. This study aimed to observe changes along and after OM in addition to routine care on pain, functioning, and quality of life in patients with four CMPDs. METHODS In this observational trial with follow-up, patients suffering from chronic neck pain (CNP, n = 10), chronic low back pain (CLBP, n = 10), chronic shoulder pain (CSP, n = 10), or chronic knee pain (CKP, n = 10) received up to six OM sessions in addition to routine care. RESULTS A total of 40 patients (73% female, mean age 47.7 ± 8.3 years, mean pain intensity 59.4 ± 12.5 mm, measured by a visual analog scale [VAS] 0-100 mm) were included. After 26 weeks, there was an improvement in the VAS pain score in the whole population (mean difference to baseline -33.1 mm [95% CI -40.5 to -25.7]), as well in the patients with the four diseases: CNP (-33.7 mm [-54.7 to -12.6]), CLBP (-28.2 mm [-47.9 to -8.4]), CSP (-32.4 [-46.8 to -18.0]), and CKP (-38.1 mm [-49.1 to -27.0]). Regarding disease-specific outcomes, we found improvements in CNP, as measured by the neck disability index (scale 0-50; mean difference -3.6 [-9.0 to 1.9]), CLBP, as measured by the low back pain rating scale (scale 0-60; -3.4 [-12.5 to 5.7]), CSP, as measured by the disabilities of the arm, shoulder and hand score (scale 0-100; -13.4 [-23.1 to -3.7]), and CKP, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (scale 0-96; -13.0 [-23.5 to -2.5]). These improvements persisted through week 52. No adverse events were observed. CONCLUSION The study observed beneficial changes along and after the OM treatment in addition to routine care in patients with four different CMPDs. High-quality, multicenter randomized controlled trials are strongly needed to compare the effectiveness of OM and standard care interventions in treating CMPDs in the future. We have provided sufficient data for sample size calculations for these trials.
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Affiliation(s)
- Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Kurt-Singer-Institute for Music Physiology and Musicians Health, Hanns Eisler School of Music Berlin, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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