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.
Complement Med Res. 2022;29(1):53-66. doi: 10.1159/000518311. Epub 2021 Aug 19.
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.
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.
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.
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.
患有慢性肌肉骨骼疼痛疾病（CMPD）的患者经常接受整骨疗法（OM），尽管疼痛疾病患者的变化仍未得到充分研究。本研究旨在观察除常规护理外，在四种 CMPD 患者中，OM 治疗对疼痛、功能和生活质量的影响。
在这项具有随访的观察性试验中，患有慢性颈痛（CNP，n=10）、慢性下腰痛（CLBP，n=10）、慢性肩痛（CSP，n=10）或慢性膝痛（CKP，n=10）的患者在常规护理的基础上接受了最多 6 次 OM 治疗。
共有 40 名患者（73%为女性，平均年龄 47.7±8.3 岁，平均疼痛强度 59.4±12.5mm，用视觉模拟评分量表[VAS]0-100mm 测量）入组。26 周后，全人群的 VAS 疼痛评分均有所改善（与基线相比的平均差异为-33.1mm[95%CI-40.5 至-25.7]），四种疾病患者也均有所改善：CNP（-33.7mm[-54.7 至-12.6]）、CLBP（-28.2mm[-47.9 至-8.4]）、CSP（-32.4mm[-46.8 至-18.0]）和 CKP（-38.1mm[-49.1 至-27.0]）。在疾病特异性结局方面，我们发现 CNP 有所改善，用颈痛残疾指数（量表 0-50；平均差异-3.6[-9.0 至 1.9]）、CLBP 用腰痛评定量表（量表 0-60；-3.4[-12.5 至 5.7]）、CSP 用手臂、肩膀和手残疾量表（量表 0-100；-13.4[-23.1 至-3.7]）和 CKP 用西部安大略省和麦克马斯特大学骨关节炎指数（量表 0-96；-13.0[-23.5 至-2.5]）测量。这些改善持续到第 52 周。未观察到不良事件。
本研究观察到除常规护理外，在四种不同 CMPD 患者中，OM 治疗在治疗过程中和治疗后均有有益的变化。未来，我们强烈需要高质量、多中心的随机对照试验来比较 OM 和标准护理干预在治疗 CMPD 方面的效果。我们已经为这些试验的样本量计算提供了足够的数据。
