Asthma and OMT? I call a BS alert on that one.
General-
Last year I would have totally been on page with you. However, I spent a couple of rotations w/ an FP/OMM guy that while not making me a "believer" did widen my perspective. Over a 6 month period I observed a chronic steroid kid (7yo) go from running a chronic gauntlet of acute exacerbations and hospitalizations to a prn albuterol user. He was being treated by this doc 2x/ month using soft tissue stuff that I really didn't understand.
Below you can find a partial informal reponse from him when I asked about the basis for his treatment.
"Treatment of the cervical spine in, essentially any respiratory condition, should include undressing the upper cervical segments which has a direct effect upon inhibition of the vagal nerve. Along with this, addressing any facilitated segments in the upper thoracic region and ribs will decrease the sympathetic drive to the upper respiratory tract. As a brief review, increased parasympathetic outflow or tone to the upper respiratory tract results in a relative bronchial constriction and production of profuse secretions. Complicating this are the facilitated upper thoracic segments which will cause vasoconstriction of the lung tissue itself. This may result in hypoperfusion of the lung tissue itself and influence the pulmonary portion of the immune system. Along with this, the hypersympathetic activity, over time, can lead to epithelial hyperplasia resulting in an increase in bronchial epithelium and goblet cells. The direct effect of this is more mucus production which tends to become thick, profuse and tenacious. The parasympathetic response primarily involves the vagus nerve which can limit normal diaphragmatic excursion resulting in a low volume breathing at a rapid rate. Flattening of the diaphragm obviously decreases volume displacement and pressure gradient not to mention decreasing lymphatic flow resulting in "congestion of tissues". Clinically I have noticed predominant rib restriction of the third and fourth ribs although I cannot give you any specific scientific or anatomic reasoning for this. I can say however that generalized rib raising does have a direct effect upon the hypersympathetic activity as well as compliance of the chest wall."
Restrictions of movement and limitations in fluid outflow are frequent foci of osteopathic tretament. I would argue that many pharm. modalities also attempt to relieve these dysfunctions.
Can most DOs remedy asthma with some 'rib raising'? Nope.
I do think that all physicians can benefit from being mindful of other philosophies and therapies. Whether these should or could be incorporated in your pratice is dependent on your training and your personal perspective.
