Effectiveness of osteopathic interventions in patients with non-specific neck pain: A systematic review and meta-analysis
Fulvio Dal Farra 1 2, Francesca Buffone 1 3 4, Roberta Giulia Risio 1, Andrea Bergna 1, Andrea Gianmaria Tarantino 1 3, Luca Vismara 1 3 5 6
1Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy 2Department of Medical Sciences and Public Health, University of Cagliari, Italy 3Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy 4PPCR, Harvard T.H. Chan School of Public Health – ECPE, Boston, USA 5Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo-Verbania, Italy
6 Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126, Turin, Italy
Objective: The aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional status in patients with non-specific neck pain (NS-NP).
Methods: A systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Randomized controlled trials (RCTs) were searched in five databases, assessed through a standardized form, and evaluated using the “13 items Cochrane risk of bias (RoB) tool”. Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria.
Results: Five articles were included in the review, and none of these was completely judged at low RoB. Four of these were included in the meta-analysis. Osteopathic interventions compared to no intervention/sham treatment showed statistically significant results for pain levels (ES = −1.57 [-2.50, −0.65]; P = 0.0008) and functional status (ES = −1.71 [-3.12, −0.31]; P = 0.02). The quality of evidence was “very low” for all the assessed outcomes. Other results were presented in a qualitative synthesis.
Conclusions: Osteopathic interventions could be effective for pain levels and functional status improvements in adults with NS-NP. However, these findings are affected by a very low quality of evidence. Therefore, further high-quality RCTs are necessary to improve the quality of evidence and generalize the results.