Osteopathic manual treatment in women with endometriosis: A scoping review on clinical symptoms, fertility and quality of life

Background

Endometriosis presents significant treatment challenges and economic burdens, necessitating the exploration of alternative therapies such as Osteopathic Manual Treatment (OMT) to potentially improve patient outcomes.

Objective

This scoping review aimed to systematically map existing research on the intervention effects of OMT's on clinical symptoms, fertility, and quality of life in women with endometriosis, and review the current quality of evidence regarding these outcomes.

Design

Databases, including PubMed, Web of Science, Cochrane Library, and others, were searched until July 31, 2024 following PRISMA-ScR guidelines. The methodological quality was evaluated using the Joanna Briggs Institute (JBI) and Newcastle-Ottawa Quality Assessment Scale (NOS).

Results

The review included thirteen studies revealing low-to-moderate quality evidence for OMT to increase pregnancy success rates and improve quality of life. There is limited evidence for improvements in clinical symptoms such as dyspareunia, and dysmenorrhea. Small sample sizes, methodological variability, and the lack of control groups in many studies limit the current evidence.

Conclusion

The synthesis discovered a body of evidence suggesting OMT's potential to improve a range of symptoms associated with endometriosis. However, the current evidence base has several methodological limitations, including small sample sizes, lack of control groups, and the predominance of observational study designs. These limitations mitigate the strength of the conclusions that can be drawn regarding OMT's efficacy; and highlights the imperative for well-designed randomized controlled trials that can offer more definitive evidence.