|
Key points:
¢Some osteopaths treat patients with functional disorders of the viscera (the insides).
¢Treatment can be techniques thought to directly influence the viscera or techniques the musculoskeletal system
Patients with sinusitis, asthma, hiatus hernia, sluggish lymphatic drainage, IBS, ME and some pelvic problems may be among those to benefit
The viscera are the guts, the contents of the chest (heart and lungs) , abdomen (digestive tract) and pelvis (organs of excretion and reproduction). The term visceral osteopathy applies to both the treatment of patients with functional disorders of these organs and to technques applied directly or indirectly to influence such disorders.
Some osteopaths practice visceral osteopathy, some don’t
Visceral osteopathy considers the affects of spinal contour and mobility on the contents of the chest, abdomen and lungs; the effect of skeletal muscle and soft tissue tone on the internal organs; the relative motion of the viscera against each other; and the intrinsic motility of the viscera. The following are just some examples of how a visceral osteopathy approach may help the patient.
A scoliosis (sideways curve) of the dorsal spine will limit the mobility, (especially on the concavity) of the ribs that attach to that part of the spine, hindering chest expansion during breathing. Lung conditions may be helped by osteopathic treatment to the spine and ribs.
The diaphragm, the dome of muscle between the thoracic and abdominal cavities. is vital for breathing. Its rim attaches to the lower ribs and dorso-lumbar junction of the spine, dysfunction here possibly interfering with effective diaphragm action and needing attention.
Diaphragm movement also effects the abdomen and its contents. It also helps venous drainage back from the lower body. Attention the mechanics of the diaphragm, either by direct manipulative techniques and/or technques for related skeletal attachments may be helpful for both gastro-intestinal and cardiac complaints. The oesophagus descends to the stomach through the diaphragm. Distortion of the hole I through which the oesophagus passes (the hiatus) can lead to hiatus hernia or acid reflux. Altered tone in the muscle of the diaphragm can distort the hiatus, and osteopathic treatment can help. Looking at the other end of the oesophagus, in the throat, is also important. There is a common postural fault called “forward head posture”, in which the head is carried forward of its normal resting position. This pulls on the long structures of the throat, including the oesophagus, tending to pull the lower end of it up through the diaphragm. An osteopath would treat the patient to help reduce the forward head posture and the pull on the oesophagus.
The action of the diaphragm in turn depends on the role of the quadratus lumborum muscle, in the loins, which attaches to the lower ribs and contracts to fix them as an anchor point for the diaphragm to work from on breathing in. Poor quadratus lumborum function, which again can arise from a variety of sources, can adversely effect diaphragm function and might have to be attended to by the osteopath.
The intestines themselves have a wall of involuntary muscle which pushes the food through the gut in a wave of contraction called peristalsis. Areas of tightness in the muscle wall can lead to a dysccoordination of peristalsis which can be part of irritable bowel syndrome. Here direct work to the gut wall, using very gentle osteopathic techniques to relax the muscle, may be needed.
The role of the diaphragm in venous drainage has been alluded to. It is relevant to the condition of varicose veins, which arise in part if there is poor blood return from the legs to the heart.
Another factor here is the calf pump, the action of the calf muscles in squeezing the blood up through the veins during walking. This action is impaired if the calf muscles are too tight or short, as can occur in wearing high heels or if ankle or knee joint mobility is restricted. Another pump is the lymphatic pump, which relies on the movement of the upper ribs to pump the lymph through the thoracic duct from the the cysterna chylae. Looking at upper rib mobility and use of the “thoracic pump” technique is useful in improving lymph flow, as in helping with lymphoedema. Again looking at fluid drainage, but higher up the body, there are osteopathic techniques to help patients with sinusitis. These are just some examples of types of osteopathic approach to the viscera.
There are many other examples of how an osteopathic perspective and manual techniques may help patients with symptoms that do not come from the spine, Visceral osteopaths do not claim to be able to ‘cure’ advanced disease within internal organs. But osteopaths may be able to intervene where organs are already not functioning at their best, but no actual organic disease has set in to account for the patient’s symptoms. There are of course many condtiions of the viscera where osteopathic treatment would not help – eg, lung cancer, endometriosis, appendicitis, liver cirrhosis and so on. These an osteopath would refer on for appropriate care. For many conditions osteopathy can work as a complement to ordinary medical treatment but is by no means meant to replace it.
There are reseach papers about IBS and Osteopathy, among the most recent is: Henry WC Hundscheid, Manon JAE Pepels, Leopold GJB Engels, Ruud JLF Loffeld (2007) Treatment of irritable bowel syndrome with osteopathy: Results of a randomized controlled pilot study Journal of Gastroenterology and Hepatology 22 (9) , 1394–1398 doi:10.1111/j.1440-1746.2006.04741.x
See also: sinusitis; breathing |
