Osteopathic Manipulative Treatment for Complex Regional Pain Syndrome: A Scoping Review of Current Evidence

Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by sensory, autonomic, and motor disturbances that can lead to significant functional impairment and decreased quality of life. The pathophysiology of CRPS is multifactorial and involves central and peripheral sensitization, autonomic dysfunction, and neurogenic inflammation. Current management for CRPS consists of pharmacologic medications for pain as well as injections and physical therapy. Physical therapy is a type of manual medicine that serves as a means of neuromodulation for pain to help patients suffering from CRPS maintain functionality and quality of life. Osteopathic manipulative therapy is another type of manual medicine whose theorized mechanisms seem to make it eligible for potential treatment of CRPS. The objective of this article is to evaluate and synthesize the available evidence regarding the use of osteopathic manipulative treatment for CRPS. A literature search was conducted utilizing MEDLINE/PubMed, Semantic Scholar, Google Scholar, Cochrane Library, and clinicaltrials.gov research databases. Articles were included if they involved patients with CRPS being treated with osteopathic manipulative treatments. A total of 404 articles were initially identified, of which four met the inclusion criteria. A risk of bias assessment was performed for the included studies. This scoping review found that evidence supporting the use of osteopathic manipulative treatment (OMT) for CRPS remains limited and heterogeneous. Further research utilizing larger, higher powered studies with standardized protocols and outcomes is required to define the potential role of OMT for patients with CRPS.