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Visceral manipulation therapy

The French osteopath and physical therapist Jean Pierre Barral claims manipulation of the visceral organs will treat neck pain, traumatic brain injuries, seatbelt injuries, GERD, bloating, nausea, chronic pelvic pain, carpal tunnel syndrome, chronic spinal dysfunction, endometriosis, bladder incontinence, and many other diseases and conditions.  Scientific evidence for these claims is clearly lacking for nearly all his claims.  The only randomized controlled trials demonstrate a much more subdued enthusiasm for the technique.  Barral has training programs for the technique, primarily in Europe.

A RCT for low back pain demonstrated no difference in visceral manipulation at 2 and 6 weeks but there was a significant difference at one year.  (Eur J Pain. 2015 Aug;19(7):899-907.)  Another study used osteopathic manipulation in 19 patients and in another 20 patients both osteopathic manipulation and visceral manipulation was used.  Both therapies were equal with the exception that energy levels were higher with the combined therapy, but the study was small and not powered enough to determine significant differences.  (J Back Musculoskelet Rehabil 2017;30(3):419-425)

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