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Optimization of Abdominal Surgery and Controlling Intractable Neuropathic Pain with Peri-operative OMT

Journal: The AAO Journal Date: 2025/06, 35(2):Pages: 7. doi: Subito , type of study: case report

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p5.xml)

Keywords:

abdominal surgery [9]
case report [702]
chronic pain [286]
male [744]
neuropathic pain [4]
OMT [3730]
osteopathic manipulative treatment [3750]
post-operative care [70]

Abstract:

Introduction: OMT effectiveness in patients with existing chronic neuropathic pain following invasive procedures are not commonly discussed. While surgery itself can induce neuropathic pain, viscerosomatics are also involved in pain pathways that propagate and feed forward a continuous loop: a maladaptive reflex known as segmental facilitation. Optimizing circulation and lymphatics before surgery can also help promote wound healing. This case study will demonstrate how OMT, coordinated before and after surgery, can reduce chronic pain exacerbations. Case: A 37-year-old man with a history of intractable migraines, Arnold Chiari I malformation, and multiple previous abdominal surgeries complained of testicular pain, migraines, and global neuropathic pain. His previous left inguinal hernia repair caused him over four weeks of daily unremitting migraines and postsurgical abdominal pain. The patient had a scheduled right inguinal hernia repair with a plan to undergo OMT perioperatively. The patient was treated one month and one week before the surgery and then two weeks postop with emphasis on visceral, craniosacral, and lymphatic techniques. Results: The patient exhibited a significant decrease in recovery time and headache exacerbations following the procedure. He reported a two-week recovery post-surgery with an overall reduction of migraine episodes by 50%. His pain was subjectively reduced by two points on his pain scale by two weeks postop which was a significant improvement to him. Discussion: Optimizing this patient’s circulation and addressing his facilitated viscerosomatic reflexes in the perioperative period not only reduced his recovery time, but toned down his baseline pain level. This case not only demonstrated the effects OMT can have on reducing neuropathic pain exacerbations following surgery, but further studies may elucidate the benefits of coordinating OMT to optimize patient recovery with other procedures.


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