Investigating inter-relationships between pain, mobility, and posture following osteopathic treatment in patients with chronic neck pain

BACKGROUND: Previous studies have investigated the benefits of osteopathic treatment on pain and disability associated with neck pain but variables associated with treatment efficacy are unclear. This study aimed to investigate whether posture or mobility is associated with changes in pain and disability following osteopathic treatment. METHODS: Twenty-one participants (15 female and 6 male) with chronic neck pain received two osteopathic treatments per week for 3 weeks. and were randomised to start treatment immediately or after a 3-week delay. Neck Disability Index (NDI), pain via Visual Analogue Scale (VAS), cervical range of motion (in two planes and about its rotational axis), and posture via craniovertebral angle (CVA) were measured. RESULTS: A large inverse correlation was seen between initial NDI and change in VAS (from initial to post treatment) following osteopathic treatment (r = -0.62, p = 0.004). Non-significant trends towards inverse correlations of moderate effect size were observed between initial CVA and change in NDI from initial to follow-up (r = -0.41, p = 0.07), and between initial rotation left and change in NDI (initial to follow up) (r = -0.44, p = 0.28). Changes in pain and disability were not associated with any other posture or mobility variables or their change. CONCLUSIONS: This study shows little evidence that neck posture or mobility, or their changes, are associated with neck disability or pain changes following osteopathic treatment. Posture and mobility measures do not seem useful for predicting clinical outcomes of manual therapy