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Abstract:
Background:
With persistent unspecific backache post partum the so called epidemiological statistics showing the frequency of this problem in previous publications vary between 9% and 50%. Up until now there are no scientific findings that show any significant success with conservative treatment methods for this problem.
Objective:
The aim of the study was to investigate whether osteopathic treatments had an effect on women with post partum persistent unspecific back pain.
Design:
Randomized controlled trial in the „Waiting list design”. Follow up six weeks after completion of treatment.
Setting:
The study was carried out by two osteopaths in their clinics in Kassel. The patients were recruited from several midwife clinics and on recommendation from the own clinics.
Patients:
In total 40 women (on average 34,5 years old) with unspecific backache post partum took part in the study, whereby the backache had to be present at least three months but not longer than 24 months and in connection with pregnancy or birth. 20 patients for the treatment group and 20 for the control group were chosen randomly.
Intervention:
The treatment group received four osteopathic treatments over an eight week period. The women in the control group remained untreated during this period.
Mean outcome measure:
The main target parameters were firstly the subjective pain felt, quantified by the Visual Analogue Scale (VAS), secondly the strength of the pain and the effect thereof on the daily life of the patient measured with the Oswestry Pain Questionnaire (OPQ).
Results:
39 participants completed the study, 20 in the treatment group and 19 in the control group. In a direct comparison between osteopathy and control group there was a statistic significance in the pain intensity as well as the OPQ (p < 0.001, 95% CI = -33.8 to – 57.6 compared to p < 0.001, 95% CI = -11.6 to -23.8). In the treatment group the intensity of the pain was reduced to the VAS average of 68.3 to 20.6, which means an improvement of 70% (p < 0.001, 95% CI = -36.5 to -58.8). The control group on the other hand only improved minimally from 3.4% (p = 0.383, 95% CI = -6.7 to 2.7). Similar results were shown in the restrictions to daily life. The measurements from the Oswestry Pain Questionnaire (OPQ) improved with the osteopathy group on average by 17,4 points, which is 62% (p < 0.001, 95% CI = -11.6 to -23.8), the control group showed a deterioration of 0.4 points. The eventual affect of external factors on these results was taken into consideration by use of a sensitivity analysis which showed no noticeable affect. In the follow up 6 weeks after the end of treatment, a further improvement of the symptoms was noted.
Conclusion:
This study shows that an osteopathic treatment for women with persistent, unspecific backache post partum brings about a clinically relevant improvement of the pain symptoms and a reduction of the impediment on daily life. The positive effect from an osteopathic treatment gives women, who are suffering, new hope that, in the future, they will be registered as a group and taken more seriously.
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