Osteopathic Research Articles

INTEGRATED APPROACH TO PAIN MANAGEMENT: YOGA, MANUAL THERAPY, FASCIA RELEASE, NERVE MOBILIZATION TECHNIQUES, OSTEOPATHIC MANIPULATIVE TREATMENT, CHIROPRACTIC CARE AND KINEMATIC AND KINETIC CHAINSANALYSIS& MUSCULOSKELETAL DYNAMICS

Chronic pain affects millions worldwide, presenting a complex challenge to conventional medical approaches. This abstract explores an integrated approach to pain management, amalgamating principles from yoga, manual therapy, fascia release, nerve mobilization, Osteopathic Manipulative Treatment, Chiropractic Careand Kinematic and Kinetic ChainsAnalysis and Musculoskeletal Dynamics. By synergizing these modalities, practitioners address pain comprehensively, targeting its multifaceted origins and manifestations.Yoga, renowned for its mind-body connection, offers a repertoire of postures and breathing exercises tailored to alleviate pain and enhance flexibility. Manual therapy techniques, including myofascial release and joint mobilization, address muscular imbalances and restore tissue integrity. Fascia release strategies delve deeper, releasing tension in the connective tissue matrix, thereby enhancing movement quality and reducing discomfort.Nerve mobilization practices target neural tension, promoting optimal nerve glide and alleviating symptoms associated with nerve compression. Concurrently, Osteopathic Manipulative Treatment, Chiropractic Care, Kinematic and Kinetic ChainsAnalysis and Musculoskeletal Dynamics to identify and rectify movement dysfunctions, ensuring harmonious joint mechanics and reducing stress on susceptible structures.Furthermore, this integrated approach extends beyond physical interventions, incorporating mindfulness practices and lifestyle adjustments to modulate pain perception and promote overall well-being. Multidisciplinary collaboration and patient education foster empowerment and long-term adherence to personalized pain management plans.In conclusion, theIntegration of Yoga, Manual Therapy, Fascia Release, Nerve Mobilization Techniques, Osteopathic Manipulative Treatment, Chiropractic Care and Kinematic and Kinetic Chains Analysis & Musculoskeletal Dynamicsrepresents a promising paradigm shift in pain management. By embracing the interconnectedness of mind, body, and environment, this holistic approach strives to restore function, alleviate suffering, and enhance the quality of life for individuals grappling with chronic pain.

The short- and long-term effect of osteopathic manipulative treatment on pain, and psychosocial factors in adults with chronic low back pain.

Chronic low back pain (CLBP) has long plagued mankind, but little progress has been made in finding a rational and effective treatment, letalone a common cause. This study is an attempt to fill that void by measuring short- and long-term effects of osteopathic manipulative treatment (OMT), including psychosocial and pain reduction in CLBP patients. The objectives of this study were to investigate the effectiveness of neuromusculoskeletal medicine/osteopathic manipulative medicine (OMM) in treating CLBP, with a focus on biopsychosocial (pain sensitivity questionnaire [PSQ]) and pain control in chronic conditions. The study involved a large, single cohort observational design of 101 patients. The inclusion criteria for selecting patients targeted those with "nonspecific" CLBP. The National Institutes of Health (NIH) Minimum Dataset for Chronic Low Back Pain (NMD) was the measurement tool and was administered at consent (baseline), 2, 4, and 8weeks and at 6 and 12months. Time trends were analyzed as overall mean. Pairwise differences were compared between time points. Mixed-effects models were utilized to test the association of time with pain and biopsychosocial scores. Pain and PSQ scores decreased over the study timeline. The most significant change for both pain and biopsychosocial scores occurred at 6months compared to baseline, with a further reduction at 12months. OMT has been demonstrated to significantly reduce pain and psychosocial factors related to CLBP in both the short and long term.

Effectiveness of comprehensive rehabilitation of patients with impaired respiratory muscle strength after coronavirus pneumonia

Aim. The study aims to evaluate the effectiveness of a comprehensive rehabilitation program for patients experiencing reduced respiratory muscle strength following coronavirus pneumonia.Materials and methods. This prospective, ran-domized study enrolled 55 individuals (average age 66.1±6.4 years; 21.8% males and 78.2% females) who had recovered from COVID-19. The rehabilitation regimen included 10 sessions of respiratory exercises, 10 chest massage treatments, and 3 sessions of osteopathic adjustment. Assessments of respiratory function and respiratory muscle strength were conducted both before the initiation of rehabilitation and upon its completion.Results. Initial complaints included rapid fatigue, dyspnea under physical strain, vertigo, headaches, chest pain during respiration, and disrupted sleep patterns. Participants were categorized into two groups: males and females. Both groups demonstrated a decrease in expiratory muscle strength by a factor of 1.2 and inspiratory muscle strength by 1.6, compared to normative values. Spirometry indicated impaired lung function across all participants. Post-rehabilitation, a marked improvement in overall health and a reduction in complaint severity were observed. Rehabilitation routing scales showed a decrease in condition severity from 2-3 points to 1-2 points, alongside a statistically significant increase in respiratory muscle strength, enhanced oxygen saturation, and restored lung function.Conclusion. Our proposed comprehensive rehabilitation program, incorporating osteopathic manipulation, respiratory exercises, and massage, successfully shifts the pathological breathing pattern to a physiological one, strengthens respiratory muscles, and reinstates lung function. This leads to improved exercise, reduced anxiety and depression levels, and enhanced quality of life for post-COVID-19 pneumonia patients.

Effects of osteopathic manipulative treatment on maternal-fetal hemodynamics in third trimester pregnant women: A prospective study.

To evaluate the maternal-fetal hemodynamic effects after osteopathic manipulative treatment by measuring vital signs and Doppler velocimetry in third-trimester pregnant women. This is a prospective study with pregnant women undergoing outpatient follow-up and hospitalized in a ward at Instituto Fernandes Figueira/Fiocruz, between August 2021 to August 2022, during the SARS-CoV-2 pandemic. This study was registered in REBEC under Register Number RBR-9q7kvg and approved by the ethics committee under number 32216620.0.0000.5269. The study population was composed of 51 pregnant women between 28 and 40 weeks of gestation, over 18 years of age, allocated in a single group. Pregnancies with multiple fetuses, malformations, premature rupture of the membrane, and active labor were excluded. The procedures evaluated maternal-fetal hemodynamics using three consecutive measures of ultrasound examination with Doppler velocimetry, and three maternal vital signs measured by an electronic blood pressure monitor. Most vital signs changed after osteopathic treatment. However, only the systolic blood pressure (109.92 ±14.42 to 110.71±12.8, p = 0.033), diastolic blood pressure (79.8±11.54 to 77.57±9.44, p = 0.018) and heart rate (87.59±11.93 to 81.12±10.26, p = 0.000) in the sitting position, systolic blood pressure (110.75±13.26 to 108.59±13.07; p = 0.034) in the supine, and heart rate (83.22±11.29 to 80.39±11.0; p = 0.013) in left lateral decubitus reached statistical significance. The oximetry measures (98.55±0.64 to 98.67±0.68; p = 0.098) stayed stable during all three positions. All artery values remained stable after treatment, and no statistically significant difference was recorded in the artery results. Responses to osteopathic treatment in women in the third trimester of pregnancy did not affect uteroplacental and fetoplacental circulation. However, some maternal vital signs had statistically significant results, with a decrease in diastolic blood pressure and heart rate, and an increase in systolic blood pressure in the sitting position, a decrease of heart rate in the left lateral decubitus position, and systolic blood pressure in the supine position. All the results observed were maintained in the normal parameters. The study responses attest to the safety of using the osteopathic manipulative treatment for the fetus and for pregnant women with comorbidities.

The changes of blood-based inflammatory biomarkers after non-pharmacologic interventions for chronic low back pain: a systematic review

BackgroundChronic low back pain (CLBP) is a prevalent and debilitating condition, leading to significant challenges to both patients and the governmental healthcare system. Non-pharmacologic interventions have received increasing attention as potential strategies to alleviate chronic low back pain and improve patient outcomes. The aim of this systematic review was to comprehensively assess the changes in blood inflammatory biomarkers after non-pharmacologic interventions for CLBP patients, thus trying to understand the complex interactions between non-pharmacologic interventions and inflammatory biomarker changes in CLBP.MethodsA thorough search (from January 1st, 2002 to October 5th, 2022) of PubMed, Medline (platform Web of Science), and the Cochrane Library (platform Wiley Online Library) were conducted, and inclusion criteria as well as exclusion criteria were refined to selection of the studies. Rigorous assessments of study quality were performed using RoB 2 from Cochrane or an adaptation of the Downs and Black checklist. Data synthesis includes alterations in inflammatory biomarkers after various non-pharmacologic interventions, including exercise, acupressure, neuro-emotional technique, and other modalities.ResultsThirteen primary studies were included in this systematic review, eight randomized controlled trials, one quasi-randomized trial, and four before-after studies. The interventions studied consisted of osteopathic manual treatment (one study), spinal manipulative therapy (SMT) (three studies), exercise (two studies), yoga (two studies) and acupressure (two studies), neuro-emotional technique (one study), mindfulness-based (one study) and balneotherapy study (one study). Four studies reported some changes in the inflammatory biomarkers compared to the control group. Decreased tumor necrosis factor-alpha (TNF-α) after osteopathic manual treatment (OMT), neuro-emotional technique (NET), and yoga. Decreased interleukin (IL)-1, IL-6, IL-10, and c-reactive protein (CRP) after NET, and increased IL-4 after acupressure. Another five studies found changes in inflammatory biomarkers through pre- and post-intervention comparisons, indicating improvement outcomes after intervention. Increased IL-10 after balneotherapy; decreased TNF-α, IL-1β, IL-8, Interferon-gamma, interferon-γ-induced protein 10-γ-induced protein 10 after exercise; decreased IL-6 after exercise and SMT; decreased CRP and chemokine ligand 3 after SMT.ConclusionResults suggest a moderation of inflammatory biomarkers due to different non-pharmacologic interventions for CLBP, generally resulting in decreased pro-inflammatory markers such as TNF-α and IL-6 as well as increased anti-inflammatory markers such as IL-4, thus revealing the inhibition of inflammatory processes by different non-pharmacologic interventions. However, a limited number of high-quality studies evaluating similar interventions and similar biomarkers limits the conclusion of this review.

Osteopathic manipulative treatment for chronic inflammatory diseases.

Chronic inflammatory diseases (CIDs) are debilitating and potentially lethal illnesses that affect a large proportion of the global population. Osteopathic manipulative treatment (OMT) is a manual therapy technique developed and performed by osteopathic physicians that facilitates the body's innate healing processes. Therefore, OMT may prove a beneficial anti-inflammatory modality useful in the management and treatment of CIDs. This work aims to objectively evaluate the therapeutic benefits of OMT in patients with various CIDs. In this review, a structured literature search was performed. The included studies involving asthma, chronic obstructive pulmonary disease, irritable bowel syndrome, ankylosing spondylitis, and peripheral arterial disease were selected for this work. Various OMT modalities, including lymphatic, still, counterstain, and muscle energy techniques, were utilized. Control treatments included sham techniques, routine care, or no treatment. OMT utilization led to variable patient outcomes in individuals with pathologies linked to CID.

A framework for the interpretation of heart rate variability applied to transcutaneous auricular vagus nerve stimulation and osteopathic manipulation.

Reports on autonomic responses to transcutaneous auricular vagus nerve stimulation (taVNS) and osteopathic manipulative techniques have been equivocal, partly due to inconsistent interpretation of heart rate variability (HRV). We developed a mechanistic framework for the interpretation of HRV based on a model of sinus node automaticity that considers autonomic effects on Phase 3 repolarization and Phase 4 depolarization of the sinoatrial action potential. The model was applied to HRV parameters calculated from ECG recordings (healthy adult humans, both genders) before (30 min), during (15 min), and after (30 min) a time control intervention (rest, n = 23), taVNS (10 Hz, 300 μs, 1-2 mA, cymba concha, left ear, n = 12), or occipitoatlantal decompression (OA-D, n = 14). The experimental protocol was repeated on 3 consecutive days. The model simulation revealed that low frequency (LF) HRV best predicts sympathetic tone when calculated from heart rate time series, while high frequency (HF) HRV best predicts parasympathetic tone when calculated from heart period time series. Applying our model to the HRV responses to taVNS and OA-D, revealed that taVNS increases cardiac parasympathetic tone, while OA-D elicits a mild decrease in cardiac sympathetic tone.

An osteopathic approach for a patient with sequela after treatment for a cheek squamous cell carcinoma

Abstract Surgical and radiation treatment for head and neck cancer are associated with both chronic and acute pain. While traditional treatment options, commonly antiepileptics and opioids, can be effective, many patients may still experience significant and debilitating pain. This case report describes a 61-year-old woman with a past medical history of spindle type squamous cell carcinoma in the left cheek that metastasized to the left parotid and submandibular glands. She was treated with surgical excision followed by radiation. She presented to the Osteopathic Manipulative Medicine clinic with the complaint of severe left sided facial pain, and limited range of motion that resolved with osteopathic manipulation.

Osteopathic Approach to a Patient with Recurring Low Back Pain following OMT results in Diagnosis of Underlying Gynecological Etiology: A Case Report

Abstract This case report describes the occurrence of acute low back pain, and the application of Osteopathic Manipulative Treatment techniques (OMT) initially resulting in resolution of the patient's presenting symptoms. When OMT is successful in resolving the patient's symptoms, this usually supports a musculoskeletal etiology; however, when confronted with recurrence of symptoms despite repeated successful resolution of these symptoms with OMT, the physician should suspect an organic etiology. This case demonstrates the importance of the osteopathic physician understanding viscerosomatic dysfunctions and the efficacy of the osteopathic approach to arriving at correct diagnoses. Of note, the osteopathic approach to a patient with recurring low back pain following OMT resulted in diagnosis of the underlying gynecological organic etiology for this patient's symptoms.

The Effects of Patient-specific Sequenced Osteopathic Manipulative Treatment by AGR on Quality of Life

Abstract Background Most osteopathic research has been technique, model, or protocol-driven which may not reflect actual clinical practice. Baseline health, mechanisms of injuries, and neuromusculoskeletal compensations are all unique per patient. An osteopathic research design that aligns with individualized patient care may better illustrate the role that OMM can play in health. Patient-specific, sequenced OMT by AGR (psOMT) addresses each patient's unique accrual of and response to somatic dysfunction throughout his or her body over time. To our knowledge, there have been no clinical studies looking at patient-specific, sequenced OMT by AGR and Quality of Life (QoL). Objectives To assess the effects of patient-specific, sequenced OMT (psOMT) in various Quality of Life areas. Methods A noncomparative study was conducted on all consenting patients of Pikeville Medical Center's OMT clinic from April 2021 to May 2022. Participants were evaluated and treated with patient-specific, sequenced OMT (psOMT) by Area of Greatest Restriction (AGR). Participants were given 2 modified PROMIS 29 Quality of Life surveys to assess nine domains of QoL. Results Participants who received psOMT showed statistically significant improvements in all 9 metrics of QoL (ρ<.001). Conclusion This study presents a paradigm for osteopathic medical research that honors each patient's unique accrual of and response to somatic dysfunction(SD) throughout their lifetime. This study suggests the following: 1) that SD may contribute to impairments in overall QoL, 2) that SD could represent a modifiable risk factor in general medical assessment, and therefore 3) that treatment of SD may contribute to improvements in QoL by relieving impairments to optimal physiologic function.

The Use of Osteopathic Manipulative Treatment for a Case of Cervical Radiculopathy

Abstract Cervical radiculopathy is a clinical condition related to dysfunction of the cervical spinal nerve roots. Signs and symptoms include unilateral neck, shoulder, or arm pain; paresthesias of the arm, forearm or hand; diminished muscle tendon reflexes, sensory disturbances; and/or muscle weakness. Cervical radiculopathy is primarily a clinical diagnosis with patients reporting a varying degree of pain and/or neurologic dysfunction along a nerve root distribution. In addition to a thorough history, a detailed physical exam including muscle strength testing, deep tendon reflex testing and sensory testing should be performed to determine the nerve root involved and to further help determine a course of action for the patient. The current case report demonstrates the impact of a somatic dysfunction component on underlying pathology of cervical spondylosis, likely driving the symptomatic component of cervical radiculopathy. By eliminating the somatic dysfunction components with the use of osteopathic manipulative treatment, the patient's system was able to function maximally within existing structural limitations and the symptoms resolved.

Prevalence and quality of medical Spanish education in US osteopathic medical schools: a national survey.

Spanish is the language in the United States with the greatest language-concordant physician deficit. Allopathic medical Spanish programs have proliferated, but the national prevalence of medical Spanish education at osteopathic medical schools has never been evaluated. The objectives of this study are to describe the medical Spanish educational landscape at US osteopathic schools and evaluate program adherence to previously established basic standards. Between March and October 2022, surveys were sent to all 44 member schools of the American Association of Colleges of Osteopathic Medicine (AACOM). For nonrespondents, data were obtained from publicly available websites. Primary surveys were sent to deans or diversity, equity, and inclusion officers at each osteopathic school to determine whether medical Spanish was offered and to identify a medical Spanish leader. Medical Spanish leaders received the secondary survey. The main measures of this study were the prevalence of medical Spanish programs at osteopathic schools and the extent to which existing programs met each of the four basic standards: having a faculty educator, providing a curricular structure, assessing learner skills, and awarding institutional course credit. We gathered medical Spanish information from 90.9 % (40/44) of osteopathic schools. Overall, 88.6 % (39/44) offered medical Spanish, of which 66.7 % (26/39) had formal curricula, 43.6 % (17/39) had faculty educators, 17.9 % (7/39) assessed learner skills, and 28.2 % (11/39) provided course credit. Only 12.8 % (5/39) of osteopathic schools with medical Spanish programs metall basic standards. Urban/suburban schools were likelier to offer medical Spanish than rural schools (p=0.020). Osteopathic schools in states with the highest Spanish-speaking populations were more likely to offer student-run initiatives (p=0.027). Most osteopathic schools provide medical Spanish education, but work is needed to improve consistency, quality, and sustainability. Future research should focus on osteopathic student language proficiency assessment, improve medical Spanish accessibility for students at rural programs, and explore the unique content areas of osteopathic medical Spanish education.

Variation in Transcript Reports Among Residency Applicants: An Anesthesia Program's Perspective.

With recent changes made to move USMLE Step 1 and COMLEX Level 1 scores to Pass/Fail, it becomes necessary to find other metrics to evaluate residency candidates. One conserved metric included in all residency applications is medical school transcripts. This study aims to highlight the highly varied transcript reporting in a new era of holistic applicant review. Medical school transcripts were extracted from the Electronic Residency Application Service applications to our anesthesiology residency program for the 2021-2022 application cycle. All personally identifiable information was removed. Results were categorized and tallied by 2 independent reviewers. Overall, we assessed transcript information from 156 allopathic and osteopathic medical schools. Transcript data were separated into 9 different categories. The most common grading system for allopathic medical schools was Pass/Fail. The most common grading system for osteopathic medical schools was Pass/Fail and Letter Grades. There were several medical schools that had unique grading systems and many of those did not provide a grading key for interpretation. Less than half of the allopathic and osteopathic schools offered Honors or High Pass in their grading systems, often with little information provided as to how these grades were earned. The information provided on medical school transcripts is extremely variable. Although many schools reported grades as Pass/Fail, there was no majority or consistent presentation among the transcripts. Much of the information provided on transcripts required interpretation by its reviewer and made the process of holistic applicant review more difficult.

Comparison of two manipulative techniques on pain and function in patients with low back pain: a double-blind clinical trial

Background: Low back pain affects a large part of the population, exerting negative impacts on the physical, social and emotional aspects of quality of life. Manipulative therapy is one of the main techniques used in the treatment, but little is known whether one technique is a more effective than another in terms of improving low back pain and functioning. Objectives: Compare two physiotherapeutic manipulation techniques (Maitland concept vs. osteopathy) and determine the impact on pain and functioning in patients with chronic low back pain. Methods: Forty-eight patients with nonspecific chronic low back pain (age: 18 to 40 years) and no contraindication for manipulation techniques participated in the study. Intervention: A single manipulation was performed in the lumbar region of the patients allocated to the Maitland group and osteopathy group. Randomization was performed using the Random Number Generator v.3.0.72 with concealed allocation. Blinding: The assessor who collected all data and the participants were blinded to the allocation to the different groups. Outcomes: Pain intensity (VAS), pressure pain threshold (algometer) and functional capacity (Roland-Morris) seven and 30 days after manipulation. Results: Both groups exhibited an improvement in the pressure pain threshold after seven days, which was maintained at 30 days. Likewise, the two groups exhibited an improvement in functional capacity after seven days, but this result was only maintained at 30 days in the Maitland group. No difference in pain intensity was found in either group after manipulation. No significant differences were found between the osteopathy and Maitland groups for any of the outcomes of interest. Conclusion: Although both methods led to improvements in the pressure pain threshold and functional capacity of the lumbar spine, no significant differences were found between the osteopathic and Maitland manipulation treatment techniques for the pain and functional capacity outcomes in patient with chronic low back pain.

Osteopathic Manipulative Treatment During Post-operative Recovery: A Scoping Review.

Surgery is a common and often necessary treatment option for a wide range of medical conditions, with an estimated 40 to 50 million surgeries performed in the US alone each year. While the various types of surgeries performed may be effective in treating or managing different conditions, the post-operative period can be challenging for patients. Osteopathic manipulative treatment (OMT) is a hands-on approach to medical care that seeks to restore balance and harmony to the body from the lens of an interconnected mind, body, and spirit. Given the potential for adverse events in patients following surgical treatments, OMT may be a viable adjunct post-operatively to enhance patient care and recovery. The purpose of this scoping review is to evaluate the state of current research examining the effectiveness of OMT in improving outcomes in post-operative patients. Three hundred articles were collected; 53 duplicates were removed. Eleven independent reviewers evaluated all 247 articles. Thirty articles were identified, including nine in general surgery, six in cardiothoracic surgery, five in orthopedic surgery, four in spinal surgery, three in neurosurgery, and three others (otolaryngology, oral/maxillofacial, and gynecologic surgery). Post-operative patients were treated with various OMT techniques with myofascial release and muscle energy being some of the most common treatments utilized in all surgical fields. Many studies demonstrated the benefits of OMT usage including significant pain relief, improved and earlier bowel function, and decreased lengths of hospital stay. This study demonstrates how OMT can be effective in reducing post-operative pain, reducing the incidence of post-operative ileus, and shortening the length of stay. Further research into the utilization of OMT in post-operative patients should be considereda potential adjunct to surgical intervention, especially in vulnerable patient populations.

A Narrative Review on the Viability of Osteopathic Manipulative Medicine in Treating Irritable Bowel Syndrome With Constipation (IBS-C).

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic abdominal pain and alterations in bowel habits, with global prevalence.The etiology of the disease is likely multifactorial; however, autonomic nervous system (ANS) dysfunction and immune-mediated inflammation may contribute the most to the hallmark symptoms of abdominal pain and altered motility of the gut. Current pharmacological therapies operate to modulate intestinal transit, alter the composition of the gut flora and control pain. Non-pharmacological approaches include dietary changes, increased physical activity, or fecal microbiota transplants. None of these therapies can modulate ANS dysfunction or impact the underlying inflammation that is likely perpetuating the symptoms of IBS. Osteopathic Manipulative Medicine (OMM) is a clinical approach focused on physical manipulation of the body's soft tissues to correct somatic dysfunctions. OMM can directly target the pathophysiology of IBS through many approaches such as ANS modulation and lymphatic techniques to modify the inflammatory mechanisms within the body. Particular OMM techniques of use are lymphatic manipulation, myofascial release, sympathetic ganglia treatment, sacral rocking, counterstrain, and viscerosomatic treatment. The aim of this study is to identify OMM treatments that can be used to potentially reduce the inflammation and ANS dysfunction associated with IBS symptoms, thereby providing a new non-pharmacological targeted approach for treating the disease.

Potential mechanisms for osteopathic manipulative treatment to alleviate migraine-like pain in female rats.

Migraines are the leading cause of disability in the United States, and the use of non-pharmaceutical treatments like osteopathic manipulative treatment (OMT) has shown promise. Despite its potential, the lack of mechanistic understanding has hindered widespread adoption. This study aims to investigate the efficacy of OMT in treating acute migraines and unravel its underlying mechanisms of action. Female rats were subjected to a "two-hit" approach to induce migraine-like pain. This involved bilateral injections of Complete Freund's Adjuvant (CFA) into the trapezius muscle (1st hit) followed by exposure to Umbellulone, a human migraine trigger, on Day 6 post-CFA (2nd hit). Soft tissue and articulatory techniques were applied to the cervical region for acute abortive or repeated prophylactic treatment. Cutaneous allodynia and trigeminal system activation were assessed through behavioral tests and immunohistochemical staining. Following Umbellulone inhalation, CFA-primed rats exhibited periorbital and hind paw allodynia. Immediate application of OMT after Umbellulone inhalation as an abortive treatment partially alleviated cutaneous allodynia. With OMT applied thrice as a prophylactic measure, complete suppression of tactile hypersensitivity was observed. Prophylactic OMT also prevented the increase of c-fos signals in the trigeminal nucleus caudalis and the elevation of calcitonin gene-related peptide expression in trigeminal ganglia induced by CFA and Umbellulone exposure at 2 h post-inhalation. These findings provide mechanistic insights into OMT's migraine-relief potential and underscore its viability as a non-pharmacological avenue for managing migraines.

The endogenous oxytocin after manipulative osteopathic treatment in full-term pregnant women.

The aim of this study is to assess whether the touch of osteopathic manipulative treatment (OMT) can affect the endogenous production of oxytocin in full-term pregnant women and the assessment of well-being following the treatment. In this study have been enrolled 57 pregnant women at full-term pregnancy (37th-41st week) for evaluation of the concentration of salivary oxytocin 2 minutes before and 2 minutes after a single session of OMT by an osteopath lasting for 30 minutes. Pre-OMT and post-OMT saliva samples were collected with the use of Salivette® salivary swabs. 7 salivary swabs were excluded from the analysis. 50 samples were analyzed with an appropriate ELISA kit. The mean OT salivary concentration pre-OMT was 89.98±16.39, and post-OMT was 100.60±19.13 tends to increase with p=0.0000051. In multivariate analysis, two subgroups show interesting data in the mean difference in OT salivary concentration post-OMT: women with painful contractions (p=0.06) and women under 35 years (p=0.09). The results of this study demonstrate that the effectiveness of OMT-increasing endogenous oxytocin is statistically significant in full-term pregnant women. The sensation of well-being found in most women indicates that there has been a predominantly central rather than peripheral oxytocin release after OMT.

The Fascial Distortion Model in Military Aircrew with Chronic Neck Pain: A Case Study.

Musculoskeletal pain can be a significant safety risk to aircrew. Flight surgeons are the primary care providers for aircrew and are responsible for safely treating musculoskeletal pain. Certain medical interventions can be used to treat pain while maintaining the ability to fly safely. A previous F-18 Naval Flight Officer presented to the flight surgeon with chronic neck pain seeking noninvasive and nonpharmacological therapy. After one Osteopathic Manual Treatment session using the Fascial Distortion Model (FDM), the patient had improved pain and function. The aircrewman reported an 83% reduction in pain and a 200% improvement in cervical Range of Motion (ROM) immediately following treatment. Neck pain is a common complaint in aircrew. This pain can become an in-flight distraction, thus increasing the risk of aviation mishaps. FDM can decrease pain and increase ROM quickly, without equipment or a large amount of space and without the use of medications that may prohibit an aircrew member from flying. This case study shows the ability to treat a uniformed aircrewman with neck pain while onboard an aircraft. FDM is a technique that can be taught to all flight surgeons. Teaching future flight surgeons FDM techniques can improve the U.S. Navy's resources by decreasing time away from work along with decreasing medical costs. The use of osteopathic manipulation treatment significantly reduced an aircrewman's pain and increased ROM with one treatment while maintaining flight status per current aeromedical waiver guidelines.

A superficial dissection approach to the sphenopalatine (pterygopalatine) ganglion to emphasize osteopathic clinical relevance.

The sphenopalatine (pterygopalatine) ganglion (SPG) is the most superficial ganglia to manipulate from the oral cavity. It has parasympathetic and sensory fibers directly affecting the paranasal sinuses as well as the palatine, nasal, pharyngeal, and lacrimal glands. The SPG can be manipulated intraorally by students and physicians utilizing osteopathic manipulative treatment (OMT) to relieve congestion associated with sinusitis, allergies, headaches, and upper respiratory infections. Within osteopathic medical education programs, students have anecdotally had difficulty identifying this ganglion due to its deep anatomic location and lack of direct visualization. In thisarticle, we discuss that cadaveric dissection with a superficial to deep approach to the SPG has the ability to allow medical students and physicians to better understand the three-dimensional location and osteopathic clinical relevance of this ganglion.