Background and Aim: 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. Methods: 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. Results: 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. Conclusion: 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.
Complement Med Res

中文翻译：

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四种慢性肌肉骨骼疼痛疾病的整骨疗法：一项观察性试验和随访

背景和目的：慢性肌肉骨骼疼痛疾病（CMPDs）患者经常使用整骨疗法（OM），尽管疼痛疾病患者的变化仍然没有得到充分研究。本研究旨在观察 OM 期间和之后的变化，以及对 4 名 CMPD 患者的疼痛、功能和生活质量的常规护理。方法：在这项带有随访的观察性试验中，患有慢性颈痛（CNP， n = 10）、慢性腰痛（CLBP， n = 10）、慢性肩痛（CSP， n = 10）或慢性膝关节疼痛（CKP， n = 10）除了常规护理外，还接受了多达 6 次 OM 治疗。结果：共纳入 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 ± 12.5 mm，通过视觉模拟量表 [VAS] 0-100 mm 测量）。26 周后，整个人群的 VAS 疼痛评分都有所改善（与基线的平均差异为 –33.1 mm [95% CI –40.5 至 –25.7]），以及患有以下四种疾病的患者：CNP（– 33.7 mm [–54.7 至 –12.6]）、CLBP（–28.2 mm [–47.9 至 –8.4]）、CSP（–32.4 [–46.8 至 –18.0]）和 CKP（–38.1 mm [–49.1 至 –27.0]） ]）。关于疾病特异性结果，我们发现 CNP 改善，通过颈部残疾指数（量表 0-50；平均差 –3.6 [–9.0 到 1.9]）测量，CLBP 改善，通过腰痛评定量表（量表测量0–60；–3.4 [–12.5 至 5.7])，CSP，通过手臂、肩部和手部的残疾评分来衡量（范围 0–100；–13.4 [–23.1 至 –3.7]），和 CKP，由西安大略和麦克马斯特大学骨关节炎指数测量（范围 0–96；–13.0 [–23.5 至 –2.5]）。这些改善一直持续到第 52 周。没有观察到不良事件。结论：该研究观察到 OM 治疗期间和之后的有益变化，以及四种不同 CMPD 患者的常规护理。非常需要高质量的多中心随机对照试验来比较 OM 和标准护理干预在未来治疗 CMPD 中的有效性。我们为这些试验的样本量计算提供了足够的数据。
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