Effect of osteopathic manipulative treatment on pain in palliative care patients: a randomized placebo-controlled clinical trial

Standard osteopathic manipulative therapy (OMT) is used as a supportive care for pain management in cancer patients.

The present study aimed to compare the efficacy of OMT with that of a sham treatment to attenuate pain in cancer patients in a palliative care unit.

This randomized clinical trial was a simple blind, monocentric, placebo-controlled study. Seventy-five patients were randomly distributed between standard and sham OMT sessions at a 1:1 ratio, receiving standard or sham treatment every 2 days for the 7 days of the study. Patients were assessed using a self-administered visual analog scale (VAS)-ranging from 0 to 100, recorded in the morning and evening. They also completed the QLQ-C15-PAL quality-of-life questionnaire on the first and last day of the study. For participants with controlled analgesia pumps, the number of analgesic doses was recorded.

The OMT group demonstrated a significant effect of days, circadian period, and group on VAS pain decrease (P < 0.05). The VAS pain score for the OMT group exhibited a notable decline from the third day (D3 pm) (P = 0.03) to D6 pm (P = 1.28 × 10^-05) with 43.2% improvement by the conclusion of the study. On D6, the quality-of-life score exhibited a tendency towards improvement. Patients with analgesia pumps showed a 31.58% reduction in their demand for analgesics (P = 0.016). No significant results were observed between D0 and D3.

It is hypothesized that OMT could prove an efficacious method of pain management in cancer patients receiving palliative care, in addition to conventional cancer treatment.