Non-Invasive Manual Osteopathy Relieves Low Back Pain

Researchers from the University of North Texas have determined that non-invasive osteopathic manual therapy will reduce low back pain in a majority of cases – avoiding expensive and invasive back surgery.

The University of North Texas researchers and Texas College of Osteopathic Medicine researchers conducted their research on 455 patients – 269 (59%) with back pain with low severity and 186 (41%) with severe low back pain.

The researchers performed their treatment research with randomization and double-blindedness using what is referred to as “sham-control.” “Sham control” refers to treatments that appear to be the same as the studied treatment but are not the prescribed treatment. In other words, they appear to be the treatment but they are not.

The researchers oversaw the treatment of the back pain patients over eight weeks of therapy, and then assessed the outcomes of the treatments after twelve weeks.

The patients were treated six times per week with Osteopathic Manual Treatment – also referred to as biomechnical treatment.

At the assessment most of the patients reported substantial improvement in pain reduction and back functioning for their particular movements. The majority of patients reported at least 50% or more reduction in pain.

Those with severe back pain had more than double the chance of significant improvement after treatment with Osteopathic Manual Therapy than those who were treated with sham treatment. And those treated with OMT had 80% chance of significant improvement on the standardized Roland-Morris Disability Questionnaire – which qualifies the mobility of the patient – as compared to those treated with the sham (placebo) therapy.

The researchers concluded that:

“The large effect size for Osteopathic Manual Therapy in providing substantial pain reduction in patients with chronic Low Back Pain of high severity was associated with clinically important improvement in back-specific functioning. Thus, Osteopathic Manual Therapy may be an attractive option in such patients before proceeding to more invasive and costly treatments.”

Osteopathic manual therapy utilizes the patient’s own relative muscle strength to help align, balance and strengthen those muscles and ligaments that support the spinal column. While most conventional medical treatments focus upon the spinal column and nerves in an isolated manner, often requiring expensive surgeries that often fail, osteopathic manual therapy utilizes safe and non-invasive guided treatments that allow the spinal region to reposition itself, rendering greater support for the lumbar region.

This article originally appeared on realnatural.org and is written by Case Adams.

Piriformis Syndrome

Piriformis syndrome is an uncommon neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk, shift our weight from one foot to another, and maintain balance. It is also used in sports that involve lifting and rotating the thighs -- in short, in almost every motion of the hips and legs.

The sciatic nerve is a thick and long nerve in the body. It passes alongside or goes through the piriformis muscle, goes down the back of the leg, and eventually branches off into smaller nerves that end in the feet. Nerve compression can be caused by spasm of the piriformis muscle.

Piriformis Syndrome Signs and Symptoms

Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time. Most cases of sciatica, however, are not due to piriformis syndrome.

Piriformis Syndrome Diagnosis

There is no definitive test for piriformis syndrome. In many cases, there is a history of trauma to the area, repetitive, vigorous activity such as long-distance running, or prolonged sitting. Diagnosis of piriformis syndrome is made by the patient’s report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle. In some cases, a contracted or tender piriformis muscle can be found on physical exam.

Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc.

Piriformis Syndrome Treatment

If pain is caused by sitting or certain activities, try to avoid positions that trigger pain. Rest, ice, and heat may help relieve symptoms. A doctor or physical therapist can suggest a program of exercises and stretches to help reduce sciatic nerve compression. Osteopathic manipulative treatment has been used to help relieve pain and increase range of motion. Some health care providers may recommend anti-inflammatory medications, muscle relaxants, or injections with a corticosteroid or anesthetic. Other therapies such as iontophoresis, which uses a mild electric current, and injection with botulinum toxin (botox) have been tried by some doctors. Using the paralytic properties of the botulinum toxin, botox injections is thought by some to relieve muscle tightness and sciatic nerve compression to minimize pain.

Surgery may be recommended as a last resort.

Prevention of Piriformis Syndrome

Since piriformis syndrome is usually caused by sports or movement that repeatedly stresses the piriformis muscle, such as running or lunging, prevention is often related to good form. Avoid running or exercising on hills or uneven surfaces. Warm up properly before activity and increase intensity gradually. Use good posture while running, walking, or exercising. If pain occurs, stop the activity and rest until pain subsides. See a health care provider as needed.

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