Visceral Treatment for Nonspecific Low Back Pain

Visceral dysfunction (e.g., mobility or restricted motility) may be the underlying cause or contributing factor in the development of nonspecific low back pain (LBP) and can be treated with osteopathic manipulative therapy (OMT). The aim of this registered systematic review (CRD42018100633) was to determine the effectiveness of visceral mobilization for nonspecific LBP and to investigate the relationship between changes in visceral range of motion and LBP symptoms. Through November 2018, peer-reviewed studies published in English or German were retrieved from the following databases: Medline, Cochrane library, Science Direct, PEDro, OSTMED.RD, and Osteo web res. Articles identified in the search were screened based on selection criteria using title and abstract. Studies were included following independent review of full-text versions. Data extraction, assessment of study quality (Risk of Bias tool and PEDro score), and data extraction (mean and standard deviation for patient-reported outcomes and impairments—pain measurements, function, and ultrasound for changes in organ mobility) were performed by two independent authors. Due to heterogeneity of study populations and methods, no meta-analysis was conducted. A total of four RCTs of moderate to good methodological quality were included. Two studies reported significant short-term (less than 3 days) improvement in pain and visceral range of motion, although the clinical significance of these differences was unclear. One study reported significant long-term differences (52 weeks) in pain and one reported medium-term (6 weeks) differences in quality of life. Jacob Marten Switters, Stefan Podar, Luke Perraton, Zuzana Machotka, Is visceral manipulation beneficial for patients with low back pain? A systematic review of the literature, International Journal of Osteopathic Medicine, Volumes 33–34, 2019, 16-23.https://www.sciencedirect.com/science/article/pii/S1746068919300112