Osteopathic treatment of patients with long-term sequelae of whiplash injury: effect on neck pain disability and quality of life.

Abstract

Objectives: The clinical sequelae and manifestation resulting from whiplash injury are defined as late whiplash syndrome (LWS). The objective of this study was to investigate whether a series of osteopathic treatments of patients with LWS may improve their symptoms.

Design: The study was designed as a two-phase (pre-post) clinical intervention study. In phase one, the patients received no treatment for 6 weeks; in phase two, they received five test-dependent osteopathic treatments.

Setting: Forty-two (42) patients (mean age 39 years) suffering from LWS due to car rear-end collisions were included.

Intervention: Five (5) individualized and custom-tailored osteopathic treatments at 1-week intervals were performed.

Main outcome measures: Main outcome parameters were the neck-related pain and disability (determined by the Neck Pain and Disability Scale [NPAD]) and the quality of life (assessed on the SF-36). The presence of a post-traumatic stress disorder (PTSD) was diagnosed.

Results: A direct comparison between the untreated period and the treatment period revealed clinically relevant and statistically significant improvements in the osteopathic treatment period for the NPAD. In the intervention phase, the NPAD dropped from 41.5 to 26.0 points, which corresponds to an improvement of 37% (95% confidence interval=11.1-19.8; p<0.0005). For the SF-36, both the physical and the mental component summary showed a significant and substantial improvement during treatment phase (p=0.009 versus p=0.02). Prior to treatment, 17 patients (43.6%) were diagnosed with a positive PTSD; this number fell to only 6 (15.4%) during observation.

Conclusions: Five (5) osteopathic treatments had a beneficial effect on the physical as well as the mental aspects of LWS and lives up to its claim of being a complementary modality in the treatment regimen of this condition. Based on these preliminary findings, rigorous randomized controlled studies are warranted.