Before he founded osteopathic medicine, Andrew Taylor Still, MD, DO, called himself a “lightning bone setter.” Therefore, it is not surprising that many osteopathic manual techniques evolved from those traditionally used in bone setting.
Bone setting is still a recognized profession in Finland, where a randomized clinical trial compared the effectiveness of bone setting with physiotherapy and massage therapy in treating adults with chronic neck pain.
In this study, traditional bone-setting treatment consisted of painless, gentle soft tissue and joint mobilization from toe to head for 90 minutes to relax tense muscles, improve joint motion, and correct body asymmetries. Physiotherapy consisted of 45 minutes of massage, therapeutic stretching, and exercise therapy as determined by the therapist, as well as an at-home stretching program. Massage therapy comprised a 1 hour session of upper body massage by a registered massage therapist. All subjects received five treatment sessions with their respective therapist every 1 to 2 weeks.
Follow-up occurred at 1, 6, and 12 months posttreatment. Outcome measures were a visual analog pain scale, self-perceived disability, global assessment, sick days, neck mobility, medication use, depression, therapist's communication, and interaction experience. Other measures included machine-measured cervical spine mobility amplitudes in horizontal, frontal, and sagittal planes as well as visual spinal flexion range in the seated position.
Researchers recruited 105 working adults (37 men, 68 women; mean age, 41.5 years) with chronic (average 11 years) neck pain. Almost all subjects (102 [97%]) completed the treatments, and 91% returned the surveys at 6-month and 1-year follow-up.
Although all three forms of treatment reduced neck pain and self-perceived disability at 1 month, subjects who received bone setting had improved global self-assessment at 1-month and 1-year follow-up. In addition, two-thirds of subjects in the bone-setting group, compared with fewer than half in each of the other groups, stated they had less disability and were satisfied with therapist communication and interaction. Subjects in the bone setting group had greater cervical and total spine range of motion and slightly fewer sick days and less medication use. Therefore, bone-setting manual therapy was considered effective and safe for patients with chronic neck pain. —MAS
Zaproudina N et al. J Manipulative Physiol Ther. 2007;30:432-437.