How effective is osteopathic manipulative treatment in managing chronic pain for spinal cord injury (SCI) patients?

In 2011, a groundbreaking study conducted at the Spinal Unit of Ospedale Niguarda Ca’ Granda and the Istituto Superiore di Osteopatia in Milan reveals promising results for individuals suffering from chronic pain due to spinal cord injuries (SCI). The research, led by Dr. C. Arienti and colleagues, explores the efficacy of combining conventional pharmacological treatments with osteopathic manipulative treatment (OMT) to alleviate pain in SCI patients.

The experimental trial enrolled 47 patients with SCI, including 26 individuals experiencing both nociceptive and neuropathic pain and 21 with pure neuropathic pain. Among the participants, 33 had complete spinal cord lesions (ASIA level A) and 14 had incomplete lesions (ASIA levels B, C, and D). The primary objective was to determine if the integration of OMT with standard pharmacological therapy could enhance pain management outcomes.

Participants were divided into three groups:

  1. Pharmacological group (Ph): Received only conventional drug treatment.
  2. Pharmacological Osteopathic group (PhO): Received a combination of drug treatment and OMT.
  3. Osteopathic group (Os): Received only OMT.

Pain levels were assessed using the verbal numeric scale (VNS) at various intervals over the treatment period.

After three weeks, the results were notable:

  • Ph Group: Achieved a 24% improvement in pain perception.
  • Os Group: Reported a 16% improvement in pain perception.
  • Both groups did not exhibit further significant improvements beyond the initial three weeks.

In stark contrast, the PhO group, receiving the combined treatment, showed significantly greater pain relief. This enhancement was evident in both patients with mixed nociceptive and neuropathic pain and those with purely neuropathic pain.

The study highlights the potential of OMT as a viable treatment option for SCI patients, particularly those for whom pharmacological options are insufficient or unsuitable. The combination of OMT with standard drug protocols not only improves pain relief but also offers a new avenue of hope for enhanced quality of life in SCI sufferers.

Dr. Arienti and his team suggest that incorporating OMT into existing treatment plans could significantly benefit SCI patients struggling with chronic pain, advocating for a broader application of this integrated approach in clinical settings.

Reference: Arienti, C., Daccò, S., Piccolo, I., & Redaelli, T. (2011). Osteopathic manipulative treatment is effective on pain control associated to spinal cord injury. Spinal Cord49(4), 515-519.

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