Osteopathic Manipulative Treatment and Short-Term Pain and Functional Outcomes in Knee and Hip Osteoarthritis: A Prospective Observational Before–After Study

Background: Evidence on osteopathic manipulative treatment (OMT) in knee and hip osteoarthritis (OA) is limited. We explored short-term pre–post changes in pain and function observed during an OMT-based program. Methods: In this prospective observational before–after study, 125 consecutive patients with knee (n = 59) or hip (n = 66) OA received 10 individualized OMT sessions over two weeks as routine care. Before and after the program, patients rated pain on a Visual Analogue Scale (VAS), and the unblinded treating therapist completed the Knee Society Score (KSS) and Harris Hip Score (composite patient-reported and examination-based scores, in unvalidated translations); changes were analyzed with Wilcoxon tests, Hodges–Lehmann estimates, and effect sizes (r). Results: In knee OA, median VAS decreased from 5.0 to 1.0 (−4.0 points, 95% confidence interval [CI] −4.5 to −3.5; r = 0.85; p < 0.001), and both KSS parts increased. In hip OA, median VAS decreased from 6.0 to 4.0 (−2.0 points, 95% CI −2.5 to −1.0; r = 0.54; p < 0.001), and all Harris Hip Score components increased. Conclusions: Pain decreased, and composite scores increased during the program, but without a control group, blinded assessment, or follow-up, these changes cannot be attributed to OMT. The findings are exploratory and intended to inform controlled trials.