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整骨手法治疗对局部关节疼痛患者疼痛程度差异的疗效:随机对照试验的荟萃分析。

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.

作者信息

DeFrancisis Jason S, Vinarski Benjamin M, Abreu Melany, Ibrahim Jalal, Hostoffer Robert

机构信息

Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA.

Internal Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.

出版信息

Cureus. 2025 Apr 21;17(4):e82724. doi: 10.7759/cureus.82724. eCollection 2025 Apr.

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 I, 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.

摘要

整骨手法治疗(OMT)是整骨医师在不同临床环境中使用的一种疗法。在众多用途中,OMT可用于缓解患者疼痛。关节疼痛是最常见的疼痛原因之一,全球数以百万计的人患有关节疼痛。这项荟萃分析考察了OMT对局部关节疼痛患者疼痛程度产生差异的疗效。这项荟萃分析包含三项研究和187名患者,使用共同效应模型发现OMT组与非OMT组之间的平均疼痛差异为-3.09(-3.57;-2.61),p<0.0001,这表明OMT在关节疼痛患者中导致了显著的疼痛差异。然而,随机效应模型显示平均差异为-1.80(-7.31;3.78),无统计学意义。此外,手头的荟萃分析有一个异质性度量指标I为96%,这表明对结果的解释应谨慎。进一步分析表明,肩部疼痛减轻对总体研究结果有显著影响,亚组分析表明OMT可使局部肩部疼痛患者的疼痛显著减轻,平均差异为-4.28(-4.86;-3.70),p<0.0001。总体而言,鉴于共同效应模型、随机效应模型和高异质性之间结果存在差异,无法就OMT是否能在关节疼痛方面造成显著差异做出确定性陈述。需要进行标准化治疗时长、更大样本量和更同质患者群体的进一步研究,以准确评估其真实影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/788f/12097846/b1a2730ad3a1/cureus-0017-00000082724-i01.jpg

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