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An Osteopathic Approach to Chronic Inflammatory Demyelinating Polyneuropathy

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 20. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

autoimmune disorder [1]
case report [514]
chronic inflammatory demyelinating polyneuropathy [1]
female [379]
immune system [40]
nervous system [169]
OMT [2951]
osteopathic manipulative treatment [2973]
women [333]

Abstract:

Introduction/Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired autoimmune disorder wherein the body attacks the myelin sheath surrounding nerve roots and peripheral nerves. It can present as bilateral symptoms of upper and lower extremity weakness, decreased sensation, decreased reflexes, and fatigue. An atypical presentation of the disease is unilateral symptoms as discussed in this case. Can osteopathic manipulative treatment (OMT) be used to improve a CIDP patient’s pain that is unresolved by medication? Case: A 56-year-old female with a diagnosis of CIDP within the last year and being treated with carbamazepine presents to the osteopathic treatment center with worsening 7/10 stabbing chronic right-sided middle and lower back pain, right-sided lower extremity numbness, and the sensation that the bones in her right foot are flipped. Osteopathic examination revealed an inhaled 9th rib, hypertonic quadratus lumborum, hypertonic iliotibial bands, and inverted right talus. Passive treatments, such as counterstain, articulatory, and soft tissue were most utilized throughout her body. Results: Over eight visits the patient reported improvement in her pain for a few days after each treatment, especially in the mid-back, and temporary resolution of the sensation of her foot being rotated in between visits. Discussion: This case-study discusses how OMT was used to improve pain unresponsive to medication in a patient with unilateral symptoms of CIDP. By treating the somatic dysfunctions resulting from the body’s compensation for decreased sensation and weakness in the extremities, OMT was able to provide even temporary relief of her pain and therefore improve the patient’s quality of life beyond medication. A limitation of this study was a change in the CIDP medication dosage making it difficult to isolate the changes in her symptoms to OMT.


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