The Benefits of Manual Therapy or Exercise as an Adjunctive Treatment for Individuals with Comorbid Post-Traumatic Stress Disorder and Chronic Musculoskeletal Pain.
Item
- Title
- The Benefits of Manual Therapy or Exercise as an Adjunctive Treatment for Individuals with Comorbid Post-Traumatic Stress Disorder and Chronic Musculoskeletal Pain.
- Author(s)
- Woodward, E
- Abstract
- Background: Post-Traumatic Stress Disorder (PTSD) is a complex condition affecting around 5% of the population following a traumatic event. Along with associated mental and physical health problems, chronic pain (CP) is commonly comorbid. Such comorbidity often leads to poorer treatment outcomes, work and social dysfunction, and alcohol and drug abuse. Traditional treatments include cognitive behavioural therapy (CBT), eye movement desensitisation and medication, with some studies suggesting an integrated approach to treatment using complementary and alternative (CAM) therapies. It appears that the focus is generally on the psychological health of the patient with little regard to their physical pain. Objective: To synthesize and critically evaluate the research over the last 15 years to see if manual therapy or exercise has been indicated in studies for comorbid PTSD and CP and therefore, if it might be a relevant adjunct to traditional treatment in providing an integrated programme to improve psychological and physiological well-being. Design: Structured literature review. Methods: 4 databases were searched for relevant articles published between 2002 and 2017. Abstracts were screened for inclusion and exclusion criteria and documented in a table. The included articles were graded for quality and strength of recommendation using the validated SORT criteria. Results: 113 studies were retrieved following title and abstract screening from a total of 133 returns. Application of inclusion and exclusion criteria resulted in 15 studies being included in the final analysis. Of these 7 were randomised controlled trials (RCTs), 2 were reviews (1 Cochrane), 2 case series studies and 4 cross sectional studies. The demographic studied were military personnel, refugees or survivors of torture or war, the general population (cause unknown), and adult survivors of childhood sexual abuse All participants were aged between 18-65; where gender was revealed, almost 81% were male. The quality of the evidence was generally low; the mode score was 2b, one review scored 1b and two studies scored 3c. Discussion: Evidence for manual therapy or exercise as an adjunctive treatment for comorbid PTSD and CP is poorly represented in the literature. While there are data to suggest that these modalities may be beneficial, the evidence is generally biased and of poor quality. Conclusion: Further high-quality trials are warranted in order to validate these treatment modalities as part of an integrated plan using the biopsychosocial model of patient care.
- presented at
- European School of Osteopathy
- Date Accepted
- 2018
- Date Submitted
- 25.1.2019 17:18:26
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16414
- Inst-Identifier
- 1229
- Keywords
- Chronic pain
- Recommended
- 0
- Item sets
- Thesis
Woodward, E, “The Benefits of Manual Therapy or Exercise as an Adjunctive Treatment for Individuals with Comorbid Post-Traumatic Stress Disorder and Chronic Musculoskeletal Pain.”, Osteopathic Research Web, accessed May 4, 2025, https://www.osteopathicresearch.org/s/orw/item/350