Osteopathic manipulation improves functional status in patients with non-specific chronic back pain in a rural outpatient setting


Context: Osteopathic manipulative treatment (OMT) is a widely used methodology for the clinical treatment of spine-related pain. Recent reports have been especially positive regarding the use of OMT for chronic back pain. However, published reports have been focused on populations available within large university-based institutions, with rural-based hospitals and their clientele unrepresented within the professional literature.

Objective: The objective of this multi-year study was to examine the effects of OMT on spine-related chronic pain and its effects on dimensions of functional ability in a rural setting served by a safety-net hospital.

Methods: In this study, 151 participants with chronic (>6 months) spine-related pain (mean age 54.58 ± 11.88 years) completed at least 2 office visits. The Oswestry Disability Index (ODI) was used to assess 10 dimensions (pain intensity, personal care, lifting, walking, sitting, sleeping, standing, sex life, social life, and travel) and a total score of functional ability related to back pain.

Results: A 2-way mixed-model, repeated-measures analysis of variance (ANOVA) with time (pre- and post-office visit) as the within-participants factor and with sex as the between-participants factor resulted in a significant main effect from pretest to posttest, (F(1,149) = 67.12, P < .001, η2p = .311), but not a significant interaction between time and gender, (F(1,149) = .426, P = .515, η2p = .003).

Conclusions: The results of this study support the hypothesis that OMT improved measures of functional ability related to pain intensity, unrelated to sex. The rural nature of the clinical setting provided a unique population for this study.


Information Technology and Cybersecurity

Document Type



Chronic pain, OMT, Oswestry disability index, Rural

Publication Date


Journal Title

AAO Journal