Osteopathic Manipulations of Post Cesarean Section Adhesions on Low Back Pain

May 24, 2026 updated by: Radwa Helmy Mohamed Faiyad, Cairo University

Effect of Osteopathic Manipulations of Post Cesarean Section Adhesions on Low Back Pain

Chronic low back pain post cesarean section adhesions represents a restricting dysfunction, mainly influences abdominal fascia that leads to major welfare and economic restrictions. Osteopathic manipulation is a drug-free non-invasive is the therapeutic application of manually guided forces to improve physiologic function and support homeostasis. The purpose of the current study is to determine the effect of osteopathic manipulations of post cesarean section adhesions on low back pain

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Chronic low back pain is a common musculoskeletal disorder affects adults with 84% prevalence. It influences lower back, and lasts at least 12 weeks. Where increased annual cesarean section rates up to 19.1% associated with scar, pelvic, abdominal and low back pain disorders. From the fascial point of view, abdominal muscles are in continuity with the thoracolumbar fascia and the pelvic floor. It has been demonstrated that they work with great synergy and guaranteed by fascial continuity .

Osteopathic manipulative technique consists of a range of direct, indirect, combined, fluid and reflex-based manual techniques that are applied specifically to a joint or non-specifically to a body area. Direct techniques apply thrust, impulse, muscle contraction, fascial loading or passive range of motion .The purpose of the current study is to determine the effect of osteopathic manipulations of post cesarean section adhesions on low back pain. Up on that 30 post cesarean women suffering from low back pain at least for 6 months from the Outpatient Clinic of Mitghamer Hospital, El-Daqahlia. Their age range 20-35 years old, BMI range≤ 25 kg /m2. They will be allocated into control group will receive analgesics. Study group will receive four weeks of analgesics, plus osteopathic manipulations once per week.

Study Type

Interventional

Enrollment (Actual)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
    • Qalubyia
      • Al Maţmar, Qalubyia, Egypt, 35611
        • Mitghamer Hospital, Mitghamer city, Qalyubia Governate

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • They suffered from low back pain and undergoes cesarean section at least 6 months before entry into study.
  • Their body mass index (BMI) will be ≤ 25 kg /m2.
  • Their age will range from 20 to 35 years.
  • They would not use any other analgesic drugs during the study period.

Exclusion Criteria:

  • Pregnancy or suspected pregnancy.
  • Recent abdominal surgery
  • Patients with severe spinal pathology (cauda equine syndrome, spinal canal stenosis, fracture of spine, discitis, infectious disease of spine).
  • Cancer.
  • Abdominal and pelvic infection, open wound, burn and skin irritation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Control Group
Fifteen Females will receive only analgesic drugs for four weeks.
Other: Control Group
Paracetamol tablets
Experimental: Study Group
Fifteen females will receive osteopathic manipulations once weekly along four weeks, plus analgesic drugs for four weeks.
Other: Control Group
Paracetamol tablets
Other: Osteopathic Manipulations
Osteopathic Manipulations (a. Myofascial release technique: Direct scar release+ Indirect scar release 'Fascial unwinding'; b. Grand Maneuver; Visceral manipulations of uterus

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual analogue scale
Time Frame: Pre-treatment, and Post-treatment of the the study treatment program afetr 4-weeks).
a self-reported pain measurement a widely utilized scale in rehabilitation. It has been shown to be valid and reliable, and its ratio scale properties make VAS the optional tool for describing pain intensity
Pre-treatment, and Post-treatment of the the study treatment program afetr 4-weeks).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Oswestry Low Back Disability Questionnaire
Time Frame: Pre-treatment, and Post-treatment of the the study treatment program after 4-weeks).
An extremely important tool that researchers and disability evaluators use to measure a patient's permanent functional disability. The test is considered the 'gold standard' of low back functional outcome tools. It consists of 10 patient-completed questions in which the response options are presented as 6-point Likert scales. Scores range from 0% (no disability) to 100% (most severe disability). Each question is scored from 0-5 (minimum to maximum).The point total from each section is summed and the then divided by the total number of questions answered and multiplied by 100 to create a percentage disability. The scores range from 0-100% with lower scores meaning less disability.
Pre-treatment, and Post-treatment of the the study treatment program after 4-weeks).
Modified Schober Test
Time Frame: Pre-treatment, and Post-treatment of the the study treatment program after4-weeks).
The Modified Schober test is designed to measure the range of lumbar flexion in patients. The positive Schober test result is when the distance between the two lines does not increase by at least 5cm when the person bends forward. The normative values were found to be 6.85 ±1.18 cm for flexion, and 2.42±0.74 cm for extension.
Pre-treatment, and Post-treatment of the the study treatment program after4-weeks).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cairo University

Investigators

  • Study Chair: Khadija S Abdulaziz, PHD, Professor of Physical Therapy for Woman's Health
  • Study Director: Mohamed A Abo Elainin, PHD, Consultant of Obstetrics and Gynecology

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2025

Primary Completion (Actual)

April 1, 2026

Study Completion (Actual)

April 1, 2026

Study Registration Dates

First Submitted

March 26, 2025

First Submitted That Met QC Criteria

March 26, 2025

First Posted (Actual)

April 2, 2025

Study Record Updates

Last Update Posted (Actual)

May 28, 2026

Last Update Submitted That Met QC Criteria

May 24, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T.REC/012/003148

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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