American Journal of Obstetrics & Gynecology
Volume 202, Issue 1 , Pages 43.e1-43.e8, January 2010

Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial

Presented at the Fourth International Symposium on Advances in Osteopathic Research, German Osteopathic Association, Schlangenbad, Wiesbaden, Germany, Oct. 6, 2007 (Dr Licciardone); the 76th Annual Conference of the American College of Osteopathic Obstetricians and Gynecologists, Tucson, AZ, March 16-19, 2009 (Dr Hensel); and the Annual Convocation of the American Academy of Osteopathy, Little Rock, AR, March 25-29, 2009 (Dr Hensel).

  • John C. Licciardone, DO, MS, MBA

      Affiliations

    • The Osteopathic Research Center, University of North Texas Health Science Center, Fort Worth, TX
    • Corresponding Author InformationReprints: John C. Licciardone, DO, MS, MBA, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107
    • ,
  • Steve Buchanan, DO

      Affiliations

    • Department of Obstetrics and Gynecology, University of North Texas Health Science Center, Fort Worth, TX
    • ,
  • Kendi L. Hensel, DO, PhD

      Affiliations

    • The Osteopathic Research Center, University of North Texas Health Science Center, Fort Worth, TX
    • ,
  • Hollis H. King, DO, PhD

      Affiliations

    • The Osteopathic Research Center, University of North Texas Health Science Center, Fort Worth, TX
    • ,
  • Kimberly G. Fulda, DrPH

      Affiliations

    • Primary Care Research Institute, University of North Texas Health Science Center, Fort Worth, TX
    • ,
  • Scott T. Stoll, DO, PhD

      Affiliations

    • The Osteopathic Research Center, University of North Texas Health Science Center, Fort Worth, TX

Received 4 February 2009; received in revised form 1 May 2009; accepted 20 July 2009. published online 23 September 2009.

Objective

To study osteopathic manipulative treatment of back pain and related symptoms during the third trimester of pregnancy.

Study Design

A randomized, placebo-controlled trial was conducted to compare usual obstetric care and osteopathic manipulative treatment, usual obstetric care and sham ultrasound treatment, and usual obstetric care only. Outcomes included average pain levels and the Roland-Morris Disability Questionnaire to assess back-specific functioning.

Results

Intention-to-treat analyses included 144 subjects. The Roland-Morris Disability Questionnaire scores worsened during pregnancy; however, back-specific functioning deteriorated significantly less in the usual obstetric care and osteopathic manipulative treatment group (effect size, 0.72; 95% confidence interval, 0.31–1.14; P = .001 vs usual obstetric care only; and effect size, 0.35; 95% confidence interval, –0.06 to 0.76; P = .09 vs usual obstetric care and sham ultrasound treatment). During pregnancy, back pain decreased in the usual obstetric care and osteopathic manipulative treatment group, remained unchanged in the usual obstetric care and sham ultrasound treatment group, and increased in the usual obstetric care only group, although no between-group difference achieved statistical significance.

Conclusion

Osteopathic manipulative treatment slows or halts the deterioration of back-specific functioning during the third trimester of pregnancy.

Key words: back pain, osteopathic manipulative treatment, physical functioning, pregnancy, randomized controlled trial

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 This research was supported in part by Grants from the Osteopathic Heritage Foundation and the National Center for Complementary and Alternative Medicine at the National Institutes of Health (Grant number K24AT002422).

 Cite this article as: Licciardone JC, Buchanan S, Hensel KL, et al. Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial. Am J Obstet Gynecol 2010;202:43.e1-8.

PII: S0002-9378(09)00843-6

doi:10.1016/j.ajog.2009.07.057

American Journal of Obstetrics & Gynecology
Volume 202, Issue 1 , Pages 43.e1-43.e8, January 2010

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