IGeL: Osteopathy for low back pain

Almost everyone knows back pain. Does it make sense to involve an osteopath in addition to conventional treatment?

Release blockages with gentle pressure: Every procedure also carries risks with osteopathy. Patients should be educated before treatment

© W & B / Michelle Günther

What is being done there?

In 1874 the American Andrew Taylor Still developed the method of osteopathy. He understood the body as a unit. Osteopaths therefore don't just treat the painful areas. With their hands they feel blockages that are supposed to hinder the interaction of connective tissue sheaths, bones, muscles, ligaments or organs in order to release them with gentle pressure. Body fluids could then, according to Still's assumption, flow again unhindered, which activates the self-healing powers.


  • Osteopaths often treat back pain that is not due to organic causes. One study found evidence that the method relieves pain better than a simulated osteopathic treatment, so it is not a placebo effect.
  • Dr. Holger Cramer, Head of Research at the Clinic for Naturopathy and Integrative Medicine, Evang. Essen-Mitte clinics. Mobilization or manipulation of the spine, which osteopaths often undertake in a similar way to chiropractors, has proven to be as pain-relieving as conventional therapies.


  • Dr. Michaela Eikermann examined for the German IGeL-Monitor whether an osteopathic treatment is recommended in addition to the standard therapy for back pain.Their verdict: "The studies only gave very slight indications of an additional benefit. But the bottom line was that we had to say: That is too poor for us."
  • The scientific studies also have major shortcomings. "The data situation is still rather meager when it comes to the question of whether osteopathy works as an individual procedure," says Cramer, who therefore only speaks of "indications of effectiveness".
  • Osteopathy carries risks like other manual procedures - especially when the spine is being worked on. Since the training to become an osteopath is not regulated by law, the professional level can be very different.


A treatment costs between 60 and 150 euros. Some statutory health insurance companies offer participation.


According to the current state of science, there is only weak evidence that an osteopathic treatment in addition to a standard therapy for low back pain has a medical benefit. The National Health Care Guideline for Doctors does not recommend them, but instead recommends exercise therapy, relaxation techniques and short-term pain relievers in low doses. Before osteopathy treatment, patients should be informed about the risks - especially when it comes to the spine.