Based on an original peer-reviewed systematic review by Seyed Mehrbod Atshani, founder of Best Osteopathy Vancouver, completed as part of his PhD (OCS) program under Dr. Shawn Pourgol. Published May 2026.
📄 Full Paper: Osteopathic Manipulative Treatment for Cancer-Related Pain in Adults: A Systematic Review by Seyed Mehrbod Atshani (2026, PDF)
Osteopathy for Cancer Pain: What the Evidence Shows
Cancer-related pain affects between 50 and 90 percent of advanced cancer patients. However, up to two-thirds of those patients still do not get adequate pain control despite drug therapy. In addition, opioids carry serious side effects including tolerance, sedation, constipation, nausea, and dependency risk.
Because of these challenges, finding safe non-drug options for cancer pain matters a great deal. As part of my PhD (OCS) program at the National University of Medical Sciences (USA) under Dr. Shawn Pourgol, I set out to answer one question: can osteopathic manual treatment help with cancer pain, and can it reduce opioid use?
Here is what I found.
How the Review Was Conducted
To find relevant studies, I searched six major databases through March 2026. These included MEDLINE, Embase, CINAHL, Scopus, the Cochrane Register, and Web of Science.
After screening over 1,200 records, four studies met the inclusion criteria. Together, they covered 214 patients with advanced solid tumours, including lung, breast, colorectal, and head and neck cancers. All participants experienced moderate to severe pain.
In each study, OMT sessions used soft-tissue mobilization, myofascial release, and articulatory techniques. Treatments ran over 4 to 8 sessions in total.
Key Findings
Osteopathic treatment consistently reduced cancer pain
All four studies showed significant short-term pain reductions with OMT. Specifically, standardized mean differences ranged from -0.5 to -0.8. For context, that is a magnitude comparable to low-dose opioid analgesia.
The strongest trial, the Arienti 2025 RCT, showed a -1.8 point difference on an 11-point scale versus sham treatment (p less than 0.001). As a result, OMT clearly outperformed the control in reducing pain.
Opioid use dropped by 28 percent
In the randomized controlled trial, patients receiving osteopathic treatment reduced opioid doses by 28 percent. In contrast, the sham group reduced doses by only 8 percent (p = 0.02).
In palliative care, this matters a great deal. Lower opioid use leads to better alertness, improved digestion, and greater overall comfort for patients.
Function and quality of life improved
Furthermore, one study found a 12 percent improvement in Barthel Index scores in the OMT group. By comparison, the control group improved by only 5 percent (p = 0.03). Quality of life trends also favoured osteopathic treatment, though these did not consistently reach statistical significance.
No serious side effects were found
Minor soreness occurred in 5 to 10 percent of participants. Nevertheless, no serious adverse events were reported across any of the four studies. This suggests that gentle OMT is safe for carefully selected cancer patients.
What This Means for Cancer Patients in Vancouver
Overall, osteopathy for cancer pain works best as an addition to standard medical care, not a replacement. In particular, gentle soft-tissue techniques are appropriate for most palliative patients, and the evidence supports their short-term effectiveness.
Patients most likely to benefit are those with moderate to severe cancer pain in palliative or supportive care. However, patients with unstable bone metastases or severe thrombocytopenia should not receive OMT. We always recommend speaking with your oncologist first.
If you are in Vancouver and would like to know whether osteopathic treatment may help with your cancer pain, our practitioners at Best Osteopathy are happy to discuss your situation.
Limitations
It is worth noting that four studies and 214 patients is a small evidence base. Moreover, cancer types, OMT protocols, and follow-up periods varied across studies. As a result, a formal meta-analysis was not possible.
Three of the four studies were also non-randomized, which increases the risk of bias. Therefore, larger randomized trials with standardized protocols and longer follow-up are still needed before osteopathy for cancer pain can be formally integrated into clinical guidelines.
About the Research
This review was led by Seyed Mehrbod Atshani, founder of Best Osteopathy Vancouver. Before entering osteopathic practice, Mehrbod worked as an ER and general physician. Because of this background, he brings a perspective that bridges conventional medicine and manual therapy.
He is a registered member of the College of Registered Manual Osteopaths (CRMO) and a supervisor in the National Academy of Osteopathy Bridge Program.
📄 Download Full Paper (PDF):
Osteopathic Manipulative Treatment for Cancer-Related Pain in Adults by Seyed Mehrbod Atshani, PhD (OCS) Candidate, 2026
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