OMT to Address the Physiologic Effects of Stress
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Danielle Emmet
OMT Minute: OMT to Address the Physiologic Effects of Stress
eVideo. Suboccipital decompression and rib raising may reduce the physiologic effects of stress.
Emotional and physical stress induce a physiologic response in the human body. Activation of the hypothalamic-pituitary-adrenal axis and arousal of the sympathetic nervous system occurs, affecting multiple organ systems. This response allows humans to adaptively respond to emotional and physical stressors; however, chronic exposure to such stressors can lead to maladaptive alterations in our stress response, hormone levels, and allostatic load.
Osteopathic manipulative treatment (OMT) may benefit patients facing chronic stress as it affects physiological and psychological markers of our stress response. Several OMT techniques, including suboccipital inhibition and rib raising (video), are associated with increased heart rate variability, improved autonomic homeostasis, decreased muscular tension, and reduced perception of stress.
Mental stress is known to cause increased muscular tension through complex neurologic reflex loops. Suboccipital inhibition, also known as suboccipital decompression, may assist in decreasing that tension and improving autonomic nervous system homeostasis by inducing a parasympathetic response. The vagus nerve, which supplies parasympathetic innervation to much of the body, exits the skull via the jugular foramen in the suboccipital region. This technique is associated with increased parasympathetic tone and heart rate variability.
Rib raising can be used to improve respiratory excursion and is believed to improve autonomic homeostasis by decreasing sympathetic tone. Its proposed mechanism of action is through the release of the costotransverse articulation, as just anterior to this joint is the sympathetic chain ganglia arising from T1-L2, which supply sympathetic innervation everywhere in the body.
Hands-on treatment of the suboccipital and thoracic regions with these OMT techniques can help osteopathic physicians care for their patients’ body, mind, and spirit by supporting their physiologic resilience and homeostasis during stressful times.
Acknowledgments
We thank Jeff Reedy for video production and editing.
Resources
1. van der Kolk BA . The body keeps the score: memory and the evolving psychobiology of posttraumatic stress. Harv Rev Psychiatry. 1994;1(5):253-65.10.3109/10673229409017088Search in Google Scholar PubMed
2. Chila AG . Foundations of Osteopathic Medicine. 3rd ed.Baltimore, MD: Lippincott Williams & Wilkins; 2011:134-161, 767-768, 783.Search in Google Scholar
3. Kuchera ML , KucheraWA. Osteopathic Considerations for Systemic Dysfunction. Rev 2nd ed.Dayton, OH: Greyden Press; 1994:iv-v.Search in Google Scholar
4. Bisagno V , CadetJL. Stress, gender, and addiction: potential roles of CRF, oxytocin and argininevasopressin. Behav Pharmacol. 2014;25(506):445-457.10.1097/FBP.0000000000000049Search in Google Scholar PubMed PubMed Central
5. Juster RP , McEwenBS, LupienSJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev. 2010;35(1):2-16.10.1016/j.neubiorev.2009.10.002Search in Google Scholar PubMed
6. Saggio G , DocimoS, PilcJ, NortonJ, GilliarW. Impact of osteopathic manipulative treatment on secretory immunoglobulin A levels in a stressed population. J Am Osteopath Assoc. 2011;111(3):143-147.Search in Google Scholar
7. Henderson AT , FisherJF, BlairJ, SheaC, LiTS, BridgesKG. Effects of rib raising on the autonomic nervous system: a pilot study using noninvasive biomarkers. J Am Osteopath Assoc. 2010;110(6):324-330.Search in Google Scholar
8. Henley CE , IvinsD, MillsM, WenFK, BenjaminBA. Osteopathic manipulative treatment and its relationship to autonomic nervous system activity as demonstrated by heart rate variability: a repeated measures study. Osteopath Med Prim Care. 2008;2:7.10.1186/1750-4732-2-7Search in Google Scholar PubMed PubMed Central
9. Giles PD , HenselKL, PacchiaCF, SmithML. Suboccipital decompression enhances heart rate variability indices of cardiac control in healthy subjects. J Altern Complement Med. 2013;19(2):92-96. doi:10.1089/acm.2011.0031Search in Google Scholar PubMed PubMed Central
10. Thayer JF , AhsF, FredriksonM, Sollers JJIII, WagerTD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 2012;36(2):747-756.10.1016/j.neubiorev.2011.11.009Search in Google Scholar PubMed
11. Wiegand S , BianchiW, QuinnTA, BestM, FotopoulosT. Osteopathic manipulative treatment for self-reported fatigue, stress, and depression in first-year osteopathic medical students. J Am Osteopath Assoc. 2015;115(2):84-93. doi:10.7556/jaoa.2015.019Search in Google Scholar PubMed
12. Fornari M , CarnevaliL, SgoifoA. Single osteopathic manipulative therapy session dampens acute autonomic and neuroendocrine responses to mental stress in healthy male participants. J Am Osteopath Assoc. 2017;117(9):559-567. doi:10.7556/jaoa.2017.110Search in Google Scholar PubMed
13. Sinha, R. The role of stress in addiction relapse. Curr Psychiatry Rep. 2007;9(5):388. doi:10.1007/s11920-007-0050-6Search in Google Scholar PubMed
14. Goeders NE . The impact of stress on addiction. Eur Neuropsychopharmacol. 2003;13(6):435-441.10.1016/j.euroneuro.2003.08.004Search in Google Scholar PubMed
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Articles in the same Issue
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- Neurobiology of Sexual Assault and Osteopathic Considerations for Trauma-Informed Care and Practice
- OMT MINUTE
- OMT to Address the Physiologic Effects of Stress
- IN MY VIEW
- Model to Reduce Unintentional Firearms Injury and Death: Safety Through Education
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- SPECIAL REPORT
- Contemporary Routes of Cannabis Consumption: A Primer for Clinicians
- AOA COMMUNICATION
- JAOA Peer Reviewers, 2017
- ORIGINAL CONTRIBUTION
- Reducing Patient No-Shows: An Initiative at an Integrated Care Teaching Health Center
- BRIEF REPORT
- Prevalence of Homelessness by Gender in an Emergency Department Population in Pennsylvania
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