NMM/OMTREVIEW ARTICLE

The efficacy of osteopathic manipulative medicine in the treatment of low back pain: a scoping review and meta-analysis of patient-reported outcomes

Kristin Putnam, DO; Kelsey Harrington, BS; Isain Zapata, PhD; Jensen Fisher, MLIS, AHIP; Matheus Cruz, BS; and Victoria Tuttle, DO
Notes and Affiliations
Notes and Affiliations

Received: January 21, 2026

Accepted: June 11, 2026

Published: July 13, 2026

  • Kristin Putnam, DO, 

    Department of Osteopathic Principles and Practice, Rocky Vista University College of Osteopathic Medicine, Englewood, CO, USA

  • Kelsey Harrington, BS, 

    Rocky Vista University College of Osteopathic Medicine, Englewood, CO, USA

  • Isain Zapata, PhD, 

    Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Englewood, CO, USA

  • Jensen Fisher, MLIS, AHIP, 

    Medical Humanities, Rocky Vista University College of Osteopathic Medicine, Englewood, CO, USA

  • Matheus Cruz, BS, 

    Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA

  • Victoria Tuttle, DO, 

    Department of Osteopathic Principles and Practice, Rocky Vista University College of Osteopathic Medicine, Englewood, CO, USA

Abstract

Context: Osteopathic manipulative treatment (OMT) has been shown to have a mild to moderate treatment effect on reducing low back pain and disability. This scoping review investigated whether OMT is an effective procedure-based approach in the treatment of mechanical low back pain in adults.

Objectives: This study aims to determine the efficacy of OMT in the treatment of mechanical low back pain with regard to pain, disability, and quality of life (QoL) utilizing both a scoping review and meta-analysis from patient-reported outcome measures.

Methods: A scoping review approach was selected due to heterogeneity in patient populations as well as intervention delivery and outcome reporting. A systematic literature search, unrestricted by language, was performed from November 2024 through June 2025 in electronic databases. Searches from the reference lists of other manuscripts identified additional studies. Only prospective randomized controlled trials (RCTs) were included; specific back pain or the use of treatment modalities other than OMT by licensed osteopathic providers were excluded. Three validated survey measures were utilized to determine outcomes: visual analog scale (VAS), Roland-Morris Disability Questionnaire (RMDQ), and the Oswestry Disability Index (ODI). Data extracted from the articles was analyzed as a meta-analysis.

Results: In total, 2,516 articles were initially identified by our search criteria. Of those, 271 underwent full article review by two independent groups, ultimately resulting in the selection of 10 prospective RCTs that utilized OMT in the treatment of adult mechanical low back pain, including pregnant women. The use of OMT in the treatment of adult mechanical low back pain shows statistically significant improvement in patients’ perception of pain (VAS), ability to perform tasks of daily living (ODI), and functional status (RMDQ).

Conclusions: This scoping review mapped RCT evidence of OMT for mechanical low back pain and conducted structured data charting with quantitative synthesis where validated outcome measures overlapped. OMT is an effective treatment for mechanical low back pain in adult populations. Findings were consistent with moderate improvement of pain, QoL, and function with the use of OMT.

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