Is there a consensus of opinion amongst UK osteopaths on the use of local spinal manipulation (SM) when treating the symptoms of a lumbar disc herniation (LDH)?
Item
- Title
- Is there a consensus of opinion amongst UK osteopaths on the use of local spinal manipulation (SM) when treating the symptoms of a lumbar disc herniation (LDH)?
- Author(s)
- Conway, J
- Abstract
- Background: LDH is commonly encountered in osteopathic practice. NICE guidelines oppose SM for LDH in spite of much research supporting its safety and efficacy. Opinion within the osteopathic profession appears similarly divided, further research is recommended. Objectives: Explore if consensus of opinion exists within a sample of UK osteopaths on the use of SM in treating patients with LDH and therefore impart an element of experiential knowledge. Design: Cross-section, observational questionnaire. Method: Questionnaire distributed to 2353 GOsC-registered osteopaths. Data capture included: baseline characteristics; judgments on SM appropriateness according to pathognomonic LDH scenario via script concordance task; clinical reasoning underpinning decision-making. Results tested for goodness-of-fit, analyzed against baseline characteristics utilizing Pearson’s X2 (significance level p<0.05). Results: Response rate 15.21% (n=358) representing 6.78% of UK profession. Majority conservative consensus in acute phase (p<0.001), no consensus when pain continued until 3-months (p=0.324), marginal conservative consensus at 6-months when LDH confirmed by MRI (p=0.002). Female responses all significantly more conservative (p<0.005). No significant conservatism differences within subgroups according to alma mater or time in practice. 34.64% believed SM non-beneficial for LDH whilst 60.61% reported benefit. 36.03% reported SM had caused worsening of LDH symptoms. Discussion: Division of opinion across osteopathic profession and between genders supports prior research. Identification of consensus on SM being contraindicated in acute phase of LDH conflicts with literature which generally supports its safety and effectiveness. In contrast to NICE guideline recommendations, the majority of participants have found SM beneficial in treating LDH. Adverse events may be more prevalent in practice than is reported in literature. Conclusion: There is a division of opinion amongst UK osteopaths regarding the safety and effectiveness of SM in treating LDH, except in the acute phase where there is majority consensus that it is contraindicated. Further research is required to quantify and classify adverse events in practice, identify comorbidities and risk factors which may pre-dispose them, and also to compare the efficacy of SM against other osteopathic methods and wider treatment modalities.
- presented at
- European School of Osteopathy
- Date Accepted
- 2018
- Date Submitted
- 25.1.2019 17:18:24
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16390
- Inst-Identifier
- 1229
- Keywords
- Spine manipulation
- Recommended
- 0
- Item sets
- Thesis
Conway, J, “Is there a consensus of opinion amongst UK osteopaths on the use of local spinal manipulation (SM) when treating the symptoms of a lumbar disc herniation (LDH)?”, Osteopathic Research Web, accessed May 3, 2025, https://www.osteopathic-research.com/s/orw/item/374