Is manual therapy part of evidence-based medicine?

Is manual therapy part of evidence-based medicine?

How Manual Therapy Works | Mechanisms & Effects

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answers (2)

Answer 1
May, 2021

Read this carefully, this is IMPORTANT!

Pain in the lower back is one of the most common reasons for seeking primary health care and decreased performance. Drug therapy for chronic back pain rarely gives a positive effect. One of the methods for treating lower back pain is manual therapy. Its effectiveness is often studied in randomized studies, the results of which are contradictory.

We present to your attention the results of a systematic review and meta-analysis, evaluating the benefits and risks of manual therapy.

Methods

Searched for randomized controlled trials (RCTs) in Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL , Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature and research registers (until May 2018).

An RCT investigated the effect of manual therapy in persons ≥18 years of age with chronic back pain with or without radiating pain.

Manual therapy was compared with recommended therapy, non-recommended therapy, false manual therapy (placebo) and manual therapy as an auxiliary therapy.

Patients were assessed for pain and functional indicators at 1, 6 and 12 months.

Results

  • The analysis included 47 RCTs (9211 participants, the average age of which ranged from 35 to 60 years). Most studies have compared manual therapy with recommended therapies.
  • Manual therapy had an efficacy comparable to recommended treatment methods in relieving pain in the short-term and a small but clinically significant improvement in function (moderate level of evidence).
  • It was shown that, in comparison with unrecommended methods of therapy, manual therapy had a small, but clinically more significant effect in terms of improving pain in the short term and a small, clinically more significant improvement in function (high-performance).
  • Approximately half of the studies investigated adverse events and serious adverse events, however, in most of them it was not clear whether the side effects were systematic. Most of them were musculoskeletal in nature and were of mild to moderate severity.

Conclusion

In patients with chronic pain in the lower back, manual therapy demonstrates a similar effect in comparison with the recommended treatment methods. At the same time, the effectiveness of manual therapy is higher than with the use of non-recommended methods of therapy.

I strongly recommend that you familiarize yourself with an effective treatment for joints and spine that can be used at home. If interested, here is the link.

Answer 2
May, 2021

More likely no than yes. The "special" philosophy of osteopathy has practically no evidence base. Osteopathy has been shown to be effective for pain in the lower back, but no more or less than conventional medicine or alternative medicine (acupuncture, chiropractic). This is due to the fact that pain most often goes away on its own and such practices have a placebo effect, but does not get sick.

http://www.cochrane.org/CD008112/BACK_spinal-manipulative-therapy-for-chronic -low-back-pain

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