Somatic dysfunction

In osteopathic medicine or chiropractic medicine, somatic dysfunction is the impaired or altered function of the musculo-skeletal system treated by osteopathic manipulative medicine (OMM) or chiropractic manipulative therapy (CMT).

Diagnosis

Somatic dysfunction is diagnosed by physical examination. The osteopathic or chiropractic physician looks for symptoms commonly represented by the mnemonic device "TARt" (Tissue texture change, Asymmetry, Restriction, and Tenderness). The physician uses techniques such as layer-by-layer palpation and intersegmental range of motion testing to make the diagnosis.

ignificance

The physical manifestation of somatic dysfunction is frequently associated reciprocally with visceral illness. Similarly, the resolution of either can aid in the resolution of the other. For example, an infection may be associated with edema (causing a tissue texture change). Lymphatic drainage aids in clearing the infection while, conversely, resolution of the infection causes clearing of associated edema. Thus the physician attempts to aid the resolution of visceral disease by eliminating its associated manifestation in the musculo-skeletal system.

Research

Research in somatic dysfunction and the use of OMM has resulted in mixed conclusions. In a famous article published the New England Journal of Medicine in November 1999, researchers concluded that OMM and traditional drug therapy resulted in equivalent resolution of lower back pain in a nearly identical time frame. The difference was that those receiving OMM required less pharmaceutical intervention. The advantage of OMM was diminution of adverse drug reactions while the disadvantage was the greater amount of physician time required for each patient.

However, a meta-analysis of six randomized controlled trials of OMT that involved blinded assessments of low back pain in ambulatory settings found from computerized bibliographic searches of MEDLINE, EMBASE, MANTIS, OSTMED, and the Cochrane Central Register of Controlled Trials, found that OMT significantly reduces low back pain. It also concluded that the level of pain reduction is greater than expected from placebo effects alone and persists for at least three months. [cite journal |author=Licciardone JC, Brimhall AK, King LN |title=Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials |journal=BMC Musculoskelet Disord |volume=6 |issue= |pages=43 |year=2005 |pmid=16080794 |pmc=1208896 |doi=10.1186/1471-2474-6-43 |url=]

References

*cite journal |author=Wilkey A, Gregory M, Byfield D, McCarthy PW |title=A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic |journal=J Altern Complement Med |volume=14 |issue=5 |pages=465–73 |year=2008 |month=Jun |pmid=18564952 |doi=10.1089/acm.2007.0796 |url=

ources

*cite book |author=Ward, Robert |title=Foundations for osteopathic medicine |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2003 |edition=2nd ed. |pages= |isbn=0-7817-3497-5 |oclc= |doi= |accessdate=