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The Effect of Osteopathic Manipulative Treatment on Stiff Person Syndrome

Journal: The Journal of the American Osteopathic Association Date: 2020/12, 120(12):Pages: e44-e45. doi: Subito , type of study: case report

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2020.157/html)

Keywords:

autonomic nervous system [145]
case report [723]
female [628]
OMT [3776]
osteopathic manipulative treatment [3796]
stiff person syndrome [2]
women [583]

Abstract:

Statement of Significance: This case utilized a holistic approach through use of osteopathic manipulative treatment (OMT), as an alternative or adjunct to medication, to improve the quality of life in a patient experiencing chronic pain secondary to a rare neurological condition. Research Methods: A 61-year-old Caucasian female previously diagnosed with SPS presented to Nova Southeastern University's Osteopathic Manipulative Medicine (OMM) clinic with complaints of diffuse pain, most severe in the low back. The pain had an insidious onset, described as constant stiffness, but waxing and waning in severity. On her initial visit she reported 3/10 pain at rest and 8/10 pain during exacerbation which occurred with certain movements and activities. The patient reported that she experiences intermittent paresthesia in the lower extremities as well as difficulty with voiding, sometimes taking 10 minutes before being able to urinate. On physical examination the patient was alert and oriented x3 but presented with significant lid lag and dilated pupils. Postural examination showed kyphosis of the thoracic spine and a scoliotic curve in the lumbar spine. Musculoskeletal and Neurological examinations revealed upper and lower extremities had 4/5 muscle strength, 2/4 deep tendon reflexes, and dermatomes intact to light touch at L2-S1 and C5-T1 bilaterally. The patient was seen for a total of four visits, each appointment three weeks apart. During each appointment, somatic dysfunctions were discovered in the following areas: Occipitoatlantal (OA) joint, cervical vertebrae, thoracic vertebrae, lumbar vertebrae, ribs, innominates, and the shoulder girdle. These somatic dysfunctions were treated with a variety of osteopathic techniques including muscle energy, direct MFR, and BLT. Data Analysis: Subjective information was utilized to determine somatic dysfunctions as well as patient-reported pain, functionality, and relief. All diagnosed somatic dysfunctions are recorded prior to treatment, then reassessed after treatment as either resolved, improved, unchanged, or worsened. Results: Following each visit, the patient reported a consistent improvement in overall pain levels: 2/10 resting pain (3/10 prior) and 4/10 pain during exacerbation (8/10 prior). In addition, she stated that she experienced “almost normal” urination that lasted several days following each treatment session. After each of the treatment sessions, the patient reported transient soreness and fatigue. Following the patient's fourth treatment, she claimed that other treatment modalities she had attempted prior were unsuccessful and the only treatment that was currently providing her relief was OMT. Conclusion: This case demonstrates that the use of OMT on patients with Stiff Person Syndrome (SPS) may be effective in alleviating pain and normalizing autonomic responses through the treatment of somatic dysfunctions with techniques such as muscle energy, direct MFR, and BLT.


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