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

Objective: 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).Methods: A systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Ran-domized 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. Results: 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 treat-ment 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.Conclusions: 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.