Suboccipital Release Research Articles

Could the Suboccipital Release Technique Result in a Generalized Relaxation and Self-Perceived Improvement? A Repeated Measure Study Design.

Background: Musculoskeletal disorders such as cervicogenic headaches present with suboccipital muscle hypertonicity and trigger points. One manual therapy intervention commonly used to target the suboccipital muscles is the suboccipital release technique, previously related to positive systemic effects. Therefore, this study aimed to determine the immediate and short-term effects of the Suboccipital Release Technique (SRT) on brainwave activity in a subgroup of healthy individuals. Methods: Data were collected from 37 subjects (20 females and 17 males, with a mean age of 24.5). While supine, the subjects underwent a head hold followed by suboccipital release. A total of four 15 s electroencephalogram (EEG) measurements were taken and a Global Rating of Change Scale was used to assess self-perception. Results: There was a statistically significant difference (p < 0.005) in various band waves under the following electrodes: AF3, F7, F3, FC5, T7, P7, O1, O2, P8, T8, and FC6. An 8-point range in the Global Rating of Change Scores with a mean score of 1.649 (SD = 1.719 and SE = 0.283) supported the hypothesis of a self-perceived benefit from the intervention. Conclusions: The results of this study indicate that the suboccipital release technique significantly affects brain wave activity throughout different brain regions. This change is likely not the result of any placebo effect and correlates highly with the subject's self-perception of a change following the intervention. These findings support the clinical use of the suboccipital release technique when a centralized effect is desired.

Effectiveness of Sub-occipital Release In Cervicogenic Vertigo

Background: Cervicogenic vertigo is defined as a sensation of rotation, resulting from an alteration of the neck proprioceptive afferents of the upper cervical spine. Sub-occipital Release, a type of Myofascial Release (MFR) is a form of manual therapy technique which can be used for the treatment of cervicogenic vertigo. Purpose: The purpose of this study is to minimize the use of equipment and patient positioning, thus making it easy for providers to treat by using the suboccipital myofascial release technique and find the effects of this technique on cervicogenic vertigo. Objective: To determine whether sub-occipital myofascial release technique in upper cervical region is more effective than the use of conventional exercises in improvement of the symptoms of cervicogenic vertigo. Setting: Otolaryngology(ENT) and orthopaedic clinics of Pune city. Method: We carried out a prospective, randomized controlled, in 60 subjects with cervicogenic vertigo who were assigned randomly to an Exercise group (N = 17) and Sub-occipital Release group (N = 17). Subjects received treatment three times a week, for 2 weeks. By the end of session, pre‑ and post‑comparison was done for the signs and symptoms of cervicogenic vertigo. Participants: Age group 20-40 years were taken for the study. Patients with other types or causes of vertigo, acute cervical fractures or atlanto-axial joint instability were excluded from the study. Outcome measure: The primary outcome measure of this study was to find the intensity of the signs and symptoms of cervicogenic vertigo by using a Dizziness Handicap Inventory-NDI Questionnaire[6] . Results: Statistical significance was found between and within the groups with respect to the signs and symptoms of cervicogenic vertigo. The results showed a statistically significant difference (P&lt;0.05) between the pre-treatment and post-treatment values for both the groups. Also, a significant improvement of signs and symptoms of cervicogenic vertigo was found in the sub-occipital group as compared to the exercise group. Conclusion: This study concluded that sub-occipital release technique is significantly effective for the treatment of cervicogenic vertigo.

Effectiveness of Sub – Occipital Release Technique for Non-Specific Neck Pain

The main objective of the study is to find the effectiveness of sub occipital release technique in neck pain reduction, improving range of movement of neck and improving quality of life. Neck pain has a greater prevalence and is increasing globally because of various causes such as faulty posture, biomechanical causes in cervical, thoracic and scapular region. Tightness in the muscle leads to pain and decreased range of movements. This would reduce the performance of the person in day to day life and slowly will become partially dependent, and this has to be rectified in earlier stage itself. Even though, many research has been performed, they were performed only in the older age group, but not in adult age group. Variability in tension produces impact on structure and functions of cervical muscles. When there is an increased tension in cervical group of muscles, it produces imbalance in tone of the cervical muscles, which leads to neck pain and disturbed daily activities. There are various studies which had proved different methods of treatment involving various modalities, medications, exercises for treating nonspecific neck pain, but the effect of sub-occipital release technique is little understood and practiced. Hence an intervention with low time consuming and evidence based technique is needed. Sub occipital release technique helps to reduce tension in the muscles, thereby helping to perform daily activities effectively. This was an experimental study with pre-post test 20 samples selected from 30 volunteers based on the inclusion criteria. Group A is treated with sub-occipital release technique for 4 weeks, 3 days / week 2 sessions / day (Frequency: 3 times in one session). Control group performs isometric exercise for 4 weeks, 3 days / week 2 sessions / day (Frequency: 3 times in one session). At the end of 30 days of treatment session, there was a significant reduction of neck pain and increased range of motion of neck Flexion from 31.9 to 36.6, Extension from39.2 to45.0, side flexion from13.8 to 18.2, rotation from39.7 to 45.5(mean values), the mean values of VAS and NDI of pretest is 1.4 and 4.94; post test value is1.6 and 2.41.The result concluded that Group A who underwent sub-occipital release technique had more effective treatment in reducing pain and improving range of movements and functional abilities for non-specific neck pain.

Effect of suboccipital release technique in forward head posture: A comparative study

Background: Forward head posture is a postural malalignment. It can lead to increased neck pain and decreased neck mobility. Objective: The purpose of this study was to find added effect of suboccipital release technique with conventional treatment on neck pain, disability, mobility, and craniovertebral angle (CVA) in forward head population. Materials and Methods: Fifty subjects with forward head posture and neck pain were randomly allocated in two groups. Experimental group (Group A) was given myofascial release to suboccipital group of muscles along with conventional treatment and control group (Group B) received conventional treatment. Subjects received treatment three times a week, for 2 weeks. By the end of session, pre- and post-comparison was done for neck pain, disability, range of motion, and CVA. Statistical Analysis: Data were analyzed with Winpepe software and Primer software using Wilcoxon signed-rank sum test, Paired t-test, and Mann–Whitney rank sum test. Results: Statistical significance was found between and within the group with respect to pain, disability, and cervical range of motion (P < 0.05). CVA had shown significant results only for within the group. Conclusion: This study concluded that suboccipital release technique along with conventional treatment significantly improve neck pain, disability, and range of motion in forward head posture.

Efficacy of Suboccipital Release and Stabilization Exercise Training in Type 1 Chiari Malformation Patient Undergoing Surgical Treatment: A Case Report

In Chiari malformation, some symptoms are known to recur after decompression surgery. To our knowledge, this is the first case for symptomatic outcome after suboccipital release and stabilization exercises the patient with type 1 Chiari malformation who has experienced surgery. The present study aims to investigate the efficacy of suboccipital release and stabilization exercise training in a patient with Type 1 Chiari Malformation undergoing surgical treatment. A 47- year-old female patient with Chiari malformation received suboccipital release and stabilization exercise training for 10 weeks. Her symptomatic parameters were evaluated, such as pain, grip and pinch strength, deep cervical flexor strength, balance and gait. After the treatment, there were improvements in pain perception, the score of performance index of deep cervical muscles, grip force, static balance and gait parameters. Suboccipital oscillation and stabilization exercises are thought to be safe and effective in patients with Chiari malformation undergoing decompression surgery

Effect of osteopathic manipulative treatment on pulmonary function testing in children with asthma.

Asthma is a leading cause of pediatric chronic illness, and poor disease control can lead to decreased quality of life and impaired academic performance. Although osteopathic manipulative treatment (OMT) has been shown to have positive effects on pulmonary function in adult patient populations, less is known about its impact in children. To evaluate changes in pulmonary function testing (PFT) in pediatric patients on the same day they received OMT compared with PFT in those who received usual care. We recruited patients between the ages of 7-18 years with a diagnosis of asthma who were receiving routine care at a primary care asthma clinic and had undergone baseline spirometry. Patients were excluded if they met any of the following criteria: clinical indication for pre- and postbronchodilator spirometry on the day of their visit, albuterol use in the last 8hours, oral steroid use in the previous 2weeks, or diagnosis of asthma exacerbation in the previous 4weeks. Eligible patients were then randomized to either an OMT or a control group. Patients in the OMT group were treated with rib raising and suboccipital release in addition to standard asthma care, while control group patients received standard care only. A second PFT was performed for patients in both groups at the end of the visit. OMT was performed by multiple osteopathic pediatric residents specifically trained for this study. Change in spirometry results (forced vital capacity [FVC], forced expiration volume in 1second [FEV1], FVC/FEV1, and forced expiratory flow 25-75%) were then compared. The study population included 58 patients: 31 (53.4%) were assigned to the OMT group and 27 (46.6%) were assigned to the standard of care group. Patients who received OMT had greater improvement in all spirometry values compared to the usual group; however, these changes were not statistically significant. The benefits of OMT on short term spirometry results in pediatric asthma patients remain unclear.

Effect of Sub Occipital Release, Myofascial Release with Iastm Tool on Cervicogenic Headache

Background: Headache referred to upper cervical vertebra i.e. (c2, c3) along with soft tissues termed ascervicogenic headache. Difficult to diagnose and treat as the cause is not clear. It is accompanied by neckpain and stiffness.Objective: This study is to evaluate the effect of sub occipital release and myofascial release with IASTMtool on cervicogenic headache.Methodology: In this randomised controlled study (RCT) 153 subjects were approached individuals whofulfilled inclusion criteria n =34 subjects were taken for the study. The demographic data of subjects alongwith the pain (Visual analogue scale (VAS)), headache intensity (Headache disability index), cervical flexionrotation test (CFRT) and cervical range of motion was evaluated. The subjects were assigned randomly bychit method in experimental group (N=17) and conventional group (N=17). In the experimental group: suboccipital release, MFR with IASTM and exercises and in conventional group: sub occipital release, MFRmanually and exercises were given for twelve sessions i.e. three sessions in a week to each group.Results: In the present study experimental and conventional group showed significant changes in postintervention (p&lt;0.05).when compared between the groups none of the outcome measures was significantstatistically but showed clinical significance in both the groups in pain, range of motion headache intensityand CFRTConclusion: This study showed that sub occipital release and myo fascial release with IASTM tool waseffective on cervicogenic headache.

Effect of Suboccipital Release on Pain Perception and Autonomic Reflex Responses to Ischemic and Cold Pain.

To determine the autonomic effects of suboccipital release (SOR) during experimentally induced pain, 16 healthy subjects (eight women, eight men) experienced ischemic (forearm postexercise muscle ischemia [PEMI]) and cold (cold pressor test [CPT]) pain. Beat-to-beat heart rate (electrocardiogram), mean arterial blood pressure (finger photoplethysmography), baroreflex sensitivity (transfer function analysis), and pain perception were measured. SOR or a sham (modified yaw; 30 cycles/min) was performed in minute 2 of pain. PEMI increased blood pressure by 23 ± 2 and 20 ± 2 mmHg; no differences occurred between SOR or yaw. PEMI modestly elevated heart rate during ischemia, followed by significant reduction from baseline with SOR (-3 ± 2 bpm) and yaw (-4 ± 2 bpm); no differences were observed between treatments. CPT increased blood pressure (SOR = 11 ± 1, yaw = 9 ± 2 mmHg) and heart rate (SOR = 10 ± 2, yaw = 8 ± 3 bpm) before SOR and yaw. Neither treatment nor sham blunted blood pressure increases (SOR = 25 ± 2, yaw = 22 ± 2 mmHg) during CPT; both decreased heart rate (SOR = -3 ± 2, yaw = -2 ± 2 bpm) from baseline. PEMI and CPT caused increased pain without treatment modulation. Following pain and manual intervention, SOR increased baroreflex sensitivity in the 0.15-0.35 Hz range and decreased R-R interval power spectral density in the 0.03-0.5 Hz range compared with yaw. To probe potential mechanisms and interactions between manual treatment and a prototypic analgesic, oral aspirin (967 mg) was given 60 minutes before testing to reduce prostaglandin synthesis. Aspirin slightly attenuated pain but neither altered cardiovascular changes to PEMI nor interacted with SOR or yaw. SOR has the capacity to modulate pain-induced autonomic control and regulation.

Quality Improvement in Athletic Training Education on Female Athlete Triad

Context: Research into the effectiveness of occipital trigger point release has not clarified whether self-administered soft tissue techniques using other devices produce the same gains in mobility and function as when the clinician delivers the manual trigger point release. Purpose: The purpose of the study is to see whether the same restoration to the superficial backline function that is achieved with a clinician-administered suboccipital release can also be obtained through a patient-administered method. Methods and Results: The study employed a randomized descriptive laboratory study in which 60 participants reported for a single data collection session, and were either put into a clinician or self-administered treatment group. There was a statistically significant main effect for the intervention, F(1,58) = 18.24, p < .001, eta = .239, indicating that both the clinician administered and the self-administered groups improved from pretest (Pre M = 4.74, SD = 7.96) to posttest (M = 6.79, SD = 7.58). But there was not a statistically significant interaction of time and group, F(1,58) = 18.24, p = .360, eta = .014, indicating that neither group outperformed the other. Interpretation: The significant clinical implication within the study was that there was no significant difference between gains in mobility between clinician administered and self-administered suboccipital release. The significant finding in this study is toe touch distance increased for all participants following a suboccipital release. Clinical Bottom Line: If a clinician properly instructs a patient on how to perform a suboccipital release, the intervention is just as successful as when the clinician performs the suboccipital release. Keywords/Key Phrases: Clinical-Related Outcomes; Manual Techniques; Myofascial Release

The Effects of the Suboccipital Release Technique on the Autonomic Nervous System in Healthy Subjects: a Pilot Study

The Effects of the Suboccipital Release Technique on the Autonomic Nervous System in Healthy Subjects: a Pilot Study

Effect of therapeutic ultrasound versus shortwave diathermy combined with suboccipital release and manual drainage techniques for chronic sinusitis: A randomized clinical trial

Background: The repeated occurrences of sinusitis hinders patients from carrying out their daily life activities efficiently. The successful application of therapeutic ultrasound and shortwave diathermy (SWD) with the addition of suboccipital release and manual techniques could develop a new paradigm in the treatment of chronic sinusitis. Objectives: The aim of the study was to compare the effect of therapeutic ultrasound versus SWD combined with suboccipital release and manual drainage techniques in chronic sinusitis in terms of pain intensity, tenderness, and quality of life. Materials and Methods: Forty-six patients with chronic sinusitis were randomly assigned to therapeutic ultrasound and SWD groups consisting of 23 patients each. Both groups received suboccipital release and manual drainage techniques and the outcome measures were assessed at baseline and after five sessions. Results: Compared with the baseline levels, pain intensity, tenderness, and quality of life significantly reduced in both the study groups (P Conclusion: Both therapeutic ultrasound and SWD combined with suboccipital release and manual drainage techniques improve pain intensity, tenderness, and quality of life in chronic sinusitis. However, ultrasound therapy showed quicker and better effects as compared to SWD along with suboccipital release and manual drainage techniques.

Effects of sternocleidomastoid muscle and suboccipital muscle soft tissue release on muscle hardness and pressure pain of the sternocleidomastoid muscle and upper trapezius muscle in smartphone users with latent trigger points.

Few studies have been performed regarding the reduction of pain in the upper trapezius (UT) muscle by applying interventions to the sternocleidomastoid (SCM) muscle, which is innervated by the same nerves.The purpose of this study was to investigate the effects of soft tissue release intervention on the SCM and suboccipital muscles with regard to muscle hardness and pressure pain threshold (PPT) of the SCM and UT muscles in smartphone users with latent myofascial trigger points (MTrPs) in the UT muscle.Seventeen smartphone users (5 men and 12 women) with latent MTrPs in the UT muscle participated in the study. This study used a single blinding, cross-over design, wherein sternocleidomastoid soft tissue release (SSTR) and suboccipital release (SR) were applied on the subjects in random order one week apart. Muscle hardness and the PPT of the SCM and UT muscles were assessed before and after the intervention.After SSTR was applied, the SCM and UT muscles showed a significant decrease in muscle hardness and a significant increase in PPT. After SR was applied, the UT muscle showed a significant decrease in muscle hardness and a significant increase in PPT. When comparing the amount of change between the SSTR and SR interventions, significant differences were found for SCM muscle hardness and PPT of the UT muscle in the SSTR intervention, compared with the SR intervention.Therefore, we suggest that, to reduce pain in the UT muscle, it may be useful to apply intervention directly to the UT muscle, as well as to the SCM muscle, which is innervated by the same nerve.

Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache

Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache

Effects of suboccipital release with craniocervical flexion exercise on craniocervical alignment and extrinsic cervical muscle activity in subjects with forward head posture

BackgroundForward head posture is a head-on-trunk malalignment, which results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise and the suboccipital release technique have been used. Objectives: The purpose of this study was to compare the immediate effects of craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise on craniovertebral angle, cervical flexion and extension range of motion, and the muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis during craniocervical flexion exercise in subjects with forward head posture. MethodsIn total, 19 subjects (7 males, 12 females) with forward head posture were recruited using G-power software. Each subject performed craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise in random order. After one intervention was performed, the subject took a 20min wash out period to minimize any carry-over effect between interventions. Craniovertebral angle, cervical flexion and extension range of motion, and the muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis were measured. A one-way, repeated-measures ANOVA was used to assess differences between the effects of the craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise interventions in the same group. ResultsCraniovertebral angle (p<0.05), cervical flexion range of motion (p<0.05), and cervical extension range of motion (p<0.001) were significantly greater after suboccipital release combined with craniocervical flexion exercise compared to craniocervical flexion exercise alone. The muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis were significantly lower during suboccipital release combined with craniocervical flexion exercise than during craniocervical flexion exercise alone across all craniocervical flexion exercise phases except the first (all p<0.05). ConclusionThe addition of suboccipital release to craniocervical flexion exercise provided superior benefits relative to craniocervical flexion exercise alone as an intervention for subjects with forward head posture.

Can Suboccipital Release Followed by Cranio-Cervical Flexion Exercise Improve Shoulder Range of Motion, Pain, and Muscle Activity of Scapular Upward Rotators in Subjects With Forward Head Posture?

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a “downstream” effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly postversus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p..05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

Effect of sub‐occipital release and systemic acetylsalicylic acid administration on pain perception and autonomic reflex responses to pain (1170.9)

To determine the autonomic effects of sub‐occipital release (SOR) during experimentally induced pain, 16 healthy subjects (8 women, 8 men) experienced ischemic (forearm post‐exercise muscle ischemia; PEMI) and cold (hand cold pressor test; CPT) pain. Heart rate (HR; ECG) and mean arterial blood pressure (MAP; photoplethysmography) were measured. SOR or a sham control (modified yaw; 30 cycles/min) was performed in the final min of experimental pain. PEMI caused increases in MAP of 23±2 and 20±2 mmHg, but no differences were observed with the addition of either SOR or yaw. PEMI modestly elevated HR during ischemia, followed by a significant reduction with SOR (‐3±2 bpm) and yaw (‐4±2 bpm) from baseline, but no differences were observed between treatment and sham. CPT increased MAP (11±1 and 9±2 mmHg) and HR (10±2 and 8±3 bpm) prior to SOR and yaw. Neither treatment nor sham blunted MAP increases (SOR = 25±2, yaw = 22±2 mmHg) to CPT, but both decreased HR (SOR = 3±2, yaw = 2±2 bpm) from baseline. To further probe potential mechanisms, systemic acetylsalicylic acid (ASA; 967 mg) was given 60 min prior to testing to reduce prostaglandin (PG) synthesis. ASA blunted pain perception but did not alter cardiovascular changes to PEMI and did not interact with SOR or yaw. These data indicate that that both SOR and sham may be affecting the parasympathetic nervous system via a non‐PG mechanism.Grant Funding Source: Supported by a grant from the American Osteopathic Association

Effect of sub‐occipital release on steady‐state and dynamic oscillatory features of the cardiovascular system (1170.7)

To determine if sub‐occipital release (SOR) modulates sympathetic control during basal conditions and in conditions with acutely increased activity, 9 healthy subjects (5 male, 4 female) participated in 2 protocols: 1) cold stress (15°C water perfused through a high‐density tube‐lined suit for 20 min) to increase sympathetic tone and 2) normothermia (34°C). In each thermal condition, subjects received in random order, SOR and yaw sham (30 cycles/min) for 2 min. Measurements included: heart rate (HR; ECG); mean arterial blood pressure (MAP; photoplethysmography); cutaneous vascular conductance (CVC; laser‐Doppler flux/MAP); stroke volume (SV; Modelflow); systemic vascular resistance (SVR; Modelflow); and low frequency (LF; 0.04‐0.15 Hz) spectral power (Fast‐Fourier Transform). Cold stress increased MAP (SOR: 90±2 to 98±2; yaw: 87±2 to 99±2 mmHg) and SVR (SOR: 15±2 to 17±2; yaw: 15±2 to 17±2 units), decreased CVC (SOR: 0.52±0.22 to 0.26±0.14; yaw: 0.46±0.15 to 0.24±0.11 units, normothermia to cold stress, respectively), and did not significantly change HR or SV. Blood pressure and laser‐Doppler flux LF spectral power also increased during cold stress. No significant differences were observed between SOR and yaw during normothermia or cold stress. These data indicate that cold stress increases sympathetic noradrenergic tone but SOR does not have the capability to modulate these variables.Grant Funding Source: Supported by a grant from the American Osteopathic Association

Using suboccipital release to control singultus: a unique, safe, and effective treatment

Hiccups, or singultus, are the result of spontaneous and repetitive contractions of the diaphragm. In most cases, episodes of singultus are benign and self-limited. However, prolonged attacks can result in significant discomfort, morbidity, and even death. Although the etiology of hiccups is theoretical at best, a wide array of treatments has been proposed with varying efficacy. Both pharmacologic and nonpharmacologic treatments target different components of the hiccup reflex, which includes the vagus and phrenic nerves, the respiratory center in the upper medulla, and the motor neurons in the diaphragm, glottis, and external intercostal muscles. In this case report, we describe the successful cessation of hiccups in a 9-year-old boy with a treatment called suboccipital release. With this approach, gentle traction and pressure is applied to the posterior neck, stretching the suboccipital muscles and fascia. The manual decompression of the vagus, and possibly phrenic, nerves interrupts the hiccup reflex and allows for normal autonomic function to be reestablished. We propose that the suboccipital release, noninvasive, simple, and with virtually no side effects, is an ideal initial treatment of singultus.