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Osteopathic Treatment of Chronic Chest Pain After Trauma

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 12-13. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/10/493538/LBORC-NUFA-Poster-Abstracts-2023-Residents)

Keywords:

case report [514]
chest pain [11]
chronic pain [204]
male [479]
OMT [2951]
osteopathic manipulative treatment [2973]
thoracic spine [56]
trauma [100]

Abstract:

Introduction/Background: Chest pain is the second most common cause for emergency room visits and accounts for nearly three million outpatient visits in the United States annually with musculoskeletal etiology making up an estimated 40% of these cases. Despite this, there is a dearth of evidence-based recommendations for effective treatment of musculoskeletal chest pain and recommendations are often vague. This case study explores osteopathic manipulative medicine (OMM) as an effective option for treatment. Case: 52-year-old male with past medical history of coronary artery disease, status post coronary artery bypass graft with one year of chronic chest pain following a bicycle accident with direct impact to hischest. He had constant sternal pain which significantly disrupted activities and sleep. Extensive priorchest imaging and cardiac evaluation were negative. There was no significant improvement withmedications, physical therapy, acupuncture, chiropractic care, or massage. Osteopathic exam and treatment was targeted towards areas of somatic dysfunctions including: rib cage, sternum, pericardialfascia, and diaphragm. Results: Patient had significant reduction in pain and stopped pain medications after one OMM treatment, with complete resolution of pain after 6 treatments over 8 weeks. Not only was he able to resume normal activities but also cancelled a scheduled cardiothoracic exploratory surgery. Discussion: There is limited guidance for treatment of patients with musculoskeletal chest pain, which is associated with a significantly impaired quality of life. This case study demonstrates resolution of chronic post-traumatic chest pain using OMM in a medically complex patient who did not improve with other commonly recommended therapies. Study may be limited by concurrent chiropractic care. Further research is recommended to explore rates of success using osteopathic medicine for the common condition of musculoskeletal chest pain.


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