Intervertebral motion: are we kidding ourselves?
Advancing the scientific understanding of manual therapy within osteopathy
Advancing the scientific understanding of manual therapy within osteopathy
The use of our hands to detect musculoskeletal problems is an important tool for osteopaths. But are we really feeling genuine differences where problems exist – or are we kidding ourselves? ‘Are We Kidding Ourselves?’ is the title of two linked projects, which together aim to put the application of manual therapy on a firmer scientific foundation.
In this project, we explored the movement between spinal vertebrae, which an osteopath can feel when they use their hands to gently move a patient’s spine back and forth during examination, and the relationship of this movement to back pain.
Research goals
Most back pain is very poorly understood. The most common form of back pain is classed as ‘idiopathic’, which means ‘of unknown cause’. However, various clues suggest that possible disruption in the normal patterns of coordination is a factor in this type of back pain.
The project aims to measure how the spine coordinates its many vertebrae, and see if there is a difference in the measurements of those with a tendency to suffer from back pain, compared to those without this tendency.
Team and collaborators
Part of this project took the form of a PhD at King’s College London by Kevin Brownhill, Research Fellow and practicing osteopath at Health Sciences University. Kevin’s supervisors were Dr (now Professor) Stephen Keevil and Dr Lewis Griffin, and he was assisted by several members of the imaging sciences department.
Kevin is now currently working with a group based at Exeter University, led by Dr Fiona Mellor.
Key Findings and Progress
During his PhD, Kevin and his team looked at differences in spinal movement, measured by MRI, between participants who suffered with recurrent back pain and those who didn’t.
The study found that participants without a history of back pain moved with greater amplitude and variability than those with. It also found that motion was more confined to the lower lumbar spine in those with a history of low back pain. Finally, it emerged that those with a history of back pain took longer to adapt to the movement task. These finding suggest changes in coordination patterns in those with a history of recurrent back pain.
Through the collaboration with the Exeter University group, a pilot study is currently underway, looking into measuring spinal motion using more up-to-date MRI technology. We hope to present our initial results at the Radiological Society of North America annual meeting in Chicago in December 2025.
Funding, impact and media
Funding and support
Kevin’s PhD was funded by the University College of Osteopathy. The collaboration with the University of Exeter is partly funded by a ‘Dragon’s Den’ fund from the department of Health and Care Professions, Exeter University.
Impact and applications
These research projects attempt to advance basic research into manual therapy. It is hoped that this will strengthen the theoretical basis of manual therapy, which is essential to guide how it can be best applied and how it can be made to be more effective.Through these projects we also seek to advance the scientific understanding of very common and disabling musculoskeletal conditions, which are at the present time remain poorly understood.
Media and publications
Initial results from the Exeter University pilot study are planned to be presented at the Radiological Society of North America annual meeting in Chicago in December 2025. Kevin’s PhD thesis is available on request.
Get involved
I am always seeking collaborators with a similar approach to idiopathic musculoskeletal pain, which aim to put the application of manual therapy on a firmer scientific foundation.
Please email kevin.brownhill@hsu.ac.uk to get in touch
