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Licensed Unlicensed Requires Authentication Published by De Gruyter October 28, 2020

Utilisation of pain counselling in osteopathic practice: secondary analysis of a nationally representative sample of Australian osteopaths

  • Kylie Fitzgerald EMAIL logo , Brett Vaughan , Michael Fleischmann , Shane Pritchard , Jane Mulcahy and Phil Austin



Advice, reassurance and education are recommended as first line treatments for musculoskeletal pain conditions such as low back pain. Osteopaths are registered primary contact allied health professionals in the Australian healthcare system who primarily manage acute and chronic musculoskeletal pain conditions. This study aimed to investigate the proportion of Australian osteopaths who do and do not utilise advice, reassurance and education (pain counselling) in their clinical practice, and determine the characteristics associated with the frequency of using pain counselling in clinical practice.


A secondary analysis of practice characteristics from a nationally representative sample of Australian osteopaths was undertaken. Participants completed a 27-item practice characteristics questionnaire between July-December 2016. Bivariate analyses were used to identify significant variables for inclusion in a backward multiple logistic regression model. Adjusted odds ratios (OR) were calculated for significant variables.


Responses were received from 991 Australian osteopaths, representing 49% of the profession. Of these 264 (26.64%) indicated often utilising pain counselling, and 727 (73.36%) reported not often utilising pain counselling. Those who utilised pain counselling were more than twice as likely to report research evidence had a high impact on their clinical practice (OR 2.11), and nearly twice as likely to discuss physical activity with their patients (OR 1.84).


Pain counselling is under-utilised by nearly three quarters of the Australian osteopathic profession as a management strategy. Future studies are required to explore the reasons why most in the profession comprised in this sample are infrequently utilising this guideline recommendation. Given the frequency of chronic musculoskeletal pain conditions presenting to Australian osteopaths, strategies appear to be needed to advance the profession via professional development in accessing and using evidence-based care for pain conditions.

Corresponding author: Kylie Fitzgerald, School of Health and Biomedical Sciences, RMIT University, Bundoora Campus, 264 Plenty Rd, Mill Park 3082, Melbourne, VIC, Australia, Phone: +61466922032, E-mail:

Award Identifier / Grant number: 501100001775


The authors would like to thank Professor Jon Adams, Dr Amie Steel and Dr Wenbo Peng from the Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney for their input into the initial stages of the analysis and data interpretation.

  1. Research funding: No funding was received for this study. The ORION project is funded by Osteopathy Australia. The funding source had no influence in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. The research reported in this paper is the sole responsibility of the authors and reflects the independent ideas and scholarship of the authors alone.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. BV & MF: Conceptualization, Data curation, Formal analysis Software, Validation, Visualization, Investigation, Methodology; BV & KF: Project administration; KF, BV & SP: Writing original draft; KF, BV, SP, MF, JM & PA: Review & editing.

  3. Competing interests: The authors report no conflict of interest in relation to the manuscript.

  4. Informed consent: Osteopaths who chose to participate in the PBRN provided informed consent.

  5. Ethical approval: Ethics approval was granted through the University of Technology Sydney (approval number: 2014000759).


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Received: 2020-04-17
Accepted: 2020-09-21
Published Online: 2020-10-28
Published in Print: 2021-04-27

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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