{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:24:05Z","timestamp":1792650245600,"version":"4.5.0"},"reference-count":31,"publisher":"Walter de Gruyter GmbH","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jom-2025-0226_abs_001\">\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Chronic low back pain (CLBP) is common and often managed within multimodal, nonpharmacologic pathways. Clarifying sham-controlled effects of osteopathic manipulative treatment (OMT) can guide early clinical decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jom-2025-0226_abs_002\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to estimate the short-term (\u22646\u00a0weeks) effects of OMT for CLBP, emphasizing sham-controlled comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jom-2025-0226_abs_003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We preregistered a systematic review and meta-analysis (PROSPERO [Prospective Register of Systematic Reviews] CRD420251154852) and followed PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020). Randomized trials enrolling adults with CLBP compared OMT with sham\/attenuated OMT, usual care, or wait-list. The co-primary outcomes were pain (0\u201310; mean difference [MD]) and function (Oswestry Disability Index [ODI] or Roland\u2013Morris Disability Questionnaire [RMDQ]; standardized mean difference [SMD]). Analyses were prespecified at end-of-treatment (\u22646\u00a0weeks); the single crossover trial contributed pre-crossover data only. Searches covered MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase (EMBASE [Excerpta Medica dataBASE]), CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index of Nursing and Allied Health), and ClinicalTrials.gov through October 2025. Random-effects models (DerSimonian\u2013Laird with Hartung\u2013Knapp) summarized effects with I\n                      <jats:sup>2<\/jats:sup>\n                      and prediction intervals (PIs); risk of bias (RoB 2) and certainty (GRADE [Grading of Recommendations, Assessment, Development, and Evaluation]) were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jom-2025-0226_abs_004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven trials (n\u2248378) met the inclusion criteria. Across five trials, OMT reduced pain vs. comparators: MD\u00a0\u22121.32 on 0\u201310 scales (95\u202f% confidence interval [CI],\u00a0\u22121.71 to\u00a0\u22120.93; I\n                      <jats:sup>2<\/jats:sup>\n                      =6\u202f%; 95\u202f% PI,\u00a0\u22122.05 to\u00a0\u22120.59). In sham-controlled analyses of function limited to ODI\/RMDQ (k=2), OMT improved disability: SMD 1.75 (95\u202f% CI, 1.37 to 2.13; I\n                      <jats:sup>2<\/jats:sup>\n                      =0\u202f%). Adverse events were infrequently reported; where monitored, no serious adverse events were attributed to OMT. Certainty by GRADE was moderate for short-term pain and for sham-controlled function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jom-2025-0226_abs_005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At\u00a0\u22646\u00a0weeks, OMT reduces pain and improves function vs. sham without observed serious harms, supporting its use as a low-risk adjunct within guideline-concordant, nonopioid CLBP\u00a0care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jom-2025-0226","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:56:20Z","timestamp":1778828180000},"source":"Crossref","is-referenced-by-count":2,"title":["Short-term benefits of osteopathic manipulative treatment for chronic low back pain: systematic review and meta-analysis"],"prefix":"10.1515","author":[{"given":"Madison","family":"Sheppard","sequence":"first","affiliation":[{"name":"Department of Osteopathic Principles and Practice , Lake Erie College of Osteopathic Medicine , Erie , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Blades","sequence":"additional","affiliation":[{"name":"Department of Osteopathic Principles and Practice , Lake Erie College of Osteopathic Medicine , Erie , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad","family":"Kabbara","sequence":"additional","affiliation":[{"name":"Department of Osteopathic Principles and Practice , Lake Erie College of Osteopathic Medicine , Erie , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arden","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Osteopathic Principles and Practice , Lake Erie College of Osteopathic Medicine , Erie , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hendryx","sequence":"additional","affiliation":[{"name":"Department of Osteopathic Principles and Practice , Lake Erie College of Osteopathic Medicine , Erie , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"2026051506561725232_j_jom-2025-0226_ref_001","unstructured":"GBD 2021 Low Back Pain Collaborators. 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