The effectiveness of osteopathic treatment in cervical whiplash: a randomized controlled trial

Whiplash is common after road traffic accidents and affects millions of people worldwide. The incidence of whiplash-associated disorders (WADs) has risen to at least 300 per 100,000 in Western countries, with global emergency room visits estimated at 235-300 per 100,000 annually.

The aim of this study was to evaluate an osteopathic intervention for whiplash and determine whether pain, mobility, and quality of life improve with respect to conventional treatment.

A randomized, controlled clinical trial (from January 13, 2021 to August 10, 2022) conducted at Hospital San Juan de Dios del Aljarafe, Bormujos (Seville), Spain. The inclusion criteria were patients with WADs grade II, aged 18-55. The exclusion criteria were previous WAD, previous osteopathic treatment, pregnancy, or neurological/rheumatic conditions. Measures included initial and final evaluations at 21 days (Visual Analog Scale [VAS], Neck Disability Index [NDI], Whiplash Disability Questionnaire [WDQ]) and WDQ re-administered at 4 weeks. The control group followed the hospital's protocol, and the experimental group also received an osteopathic intervention (n=52, 26 in each group). Statistical analysis was performed utilizing Statistical Package for the Social Sciences (SPSS) version 27.0. An intra-subject comparison was conducted with student's t-test for dependent samples and Wilcoxon's test, and inter-group comparisonswere performed utilizing student's t-test for independent samples as well as Mann-Whitney U, and chi-squared tests.

Significant improvements were obtained in the intervention group at 7, 14, and 21 days for pain (decrease of two units at each time point; p<0.001), number of pain sites (decrease of one additional unit; p<0.001), and number of medications taken (decrease of one additional unit; p=0.004; p=0.002; p=0.051). The WDQ administered at 4 weeks showed a greater improvement in the intervention group (-62.5 [IR: -73.0 to -47.5] vs. -43.5 [-56.3 to -34.0]; p=0.004) and at 21 days in the control group (-88.0 [-99.5 to -53.5] vs. -62.0 [-76.3 to -37.8]; p=0.035). The algometer for the left trapezius was better for the intervention group (0.7 [(0.12-1.0] vs. 1.0 [0.5-1.5]; p=0.029).

A significant improvement was observed for the intervention group in terms of pain, number of sites, medications taken, and at 4 weeks posttreatment in the WDQ. These findings emphasize the significance of a personalized and comprehensive osteopathic approach in the treatment of WADs.