Abstract
Background and purpose
There is on-going debate about a possible link between manipulation and stroke in patients, and a growing interest in other treatment reactions such as increased pain. Evidence about manipulation is contradictory. There is little published information about outcomes in osteopathy. We aimed to address this gap.
Methods and results
A survey was sent to all UK practising osteopaths. Another survey was sent to patients recruited by osteopaths. Patients were surveyed before treatment, one day and two days after treatment and at six weeks. 1,082 (27.8%) osteopaths completed the practitioner survey. 2,057 patients, recruited from 212 osteopaths, completed questionnaires before, and directly after their treatment. 1,387 patients provided data six weeks after treatment.
Between 10% and 20% of patients experienced increased symptoms/pain related to their main complaint in the days directly following treatment. This was highest for new patients. At 6 weeks, 4% of patients reported temporary disability, which they attributed to osteopathic treatment. 10% of patients reported seeking further consultation for worsening symptoms associated with osteopathic care. The comparison between those that received manipulation and those that did not suggests that manipulation was not linked to worsening outcomes.
In the preceding year, 4% of osteopaths reported that they had patients who experienced a range of serious events. The most common event described was the occurrence of peripheral neurological symptoms. There were also 7 reports of stroke-like symptoms.
Conclusion
Serious adverse events are rare. Transient increase in intensity of pain/symptoms is common.
Conflict of interest: S Vogel, T Mars and R Froud are osteopaths. S Vogel, and T Pincus have received payment for keynote presentations by the General Osteopathic Council. M Underwood has received payment for the delivery of a keynote presentation by the British Osteopathic Association.
Sources of funding: The majority of funding was provided by the General Osteopathic Council. Some additional funding was provided by the British School of Osteopathy.
