Effectiveness of osteopathic interventions in patients with non-specific neck pain: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional status in patients with non-specific neck pain (NS-NP). A systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Randomized controlled trials (RCTs) were searched in five databases, assessed through a standardized form, and evaluated using the “13 items Cochrane risk of bias (RoB) tool”. Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria. Five articles were included in the review, and none of these was completely judged at low RoB. Four of these were included in the meta-analysis. Osteopathic interventions compared to no intervention/sham treatment showed statistically significant results for pain levels (ES = −1.57 [-2.50, −0.65]; P = 0.0008) and functional status (ES = −1.71 [-3.12, −0.31]; P = 0.02). The quality of evidence was “very low” for all the assessed outcomes. Other results were presented in a qualitative synthesis. Osteopathic interventions could be effective for pain levels and functional status improvements in adults with NS-NP. However, these findings are affected by a very low quality of evidence. Therefore, further high-quality RCTs are necessary to improve the quality of evidence and generalize the results.