This blog post aims to assess how osteopathic treatment impacts the autonomic nervous
system. It also aims to determine whether specific treatments in different body regions can influence sympathetic or parasympathetic activity, potentially addressing a range of systemic issues.
The 23 studies analised comprise of 10 Randomized Controlled Trials (RCTs), 1 multi-center clinical study, 1 Controlled Clinical Trial (CCT), 5 Randomized Cross-over Studies, 5 Randomized Pilot Studies, and 1 Single Case Study.
Understanding Osteopathic Healthcare
Osteopathic healthcare operates on the foundational principle of holistic well-being, addressing both the structural and functional dimensions of the human body. Grounded in five distinct models, namely the postural-biomechanical, respiratory-circulatory, bioenergetic-metabolic, biopsychosocial, and neurologic-anatomic models, osteopathy embodies a multifaceted approach to healing.
The Role of Osteopathic Care in ANS Regulation
Central to osteopathic intervention is the modulation of the autonomic nervous system (ANS), which governs vital physiological functions such as heart rate, blood pressure, and temperature regulation. Dysregulation of the ANS can manifest in various distressing symptoms, underscoring the importance of targeted therapeutic interventions.
High-velocity low-amplitude techniques (HVLAT), commonly known as a "click" by the patients, applied to the cervical spine were investigated in six studies to determine their impact on the autonomic nervous system (ANS). One study, which involved 30 subjects and evaluated techniques in both the upper and lower cervical spine, demonstrated statistically significant changes in ANS function. Similarly, another study focusing on the upper cervical region, with 25 healthy participants, reported significant alterations in ANS activity. However, inconsistencies in findings across studies were noted due to variations in measurement tools and methodologies.
In the lumbar (low back) region, two studies explored the effects of HVLAT techniques. One study observed significant changes in ANS modulation among 22 subjects with acute low back pain, while another study highlighted significant alterations in parasympathetic activity following a HVLAT technique targeting L5.
Eight studies investigated the influence of cranial osteopathic manipulative treatment (OMT) techniques on the ANS. Results varied, with some studies reporting significant changes in parasympathetic activity, particularly in techniques targeting the suboccipital region.
Four studies examined the effects of mobilisation techniques in the thoracic and cervical spine on the ANS. Findings indicated alterations in autonomic function, particularly in sympathetic activity. However, consistent determination of the specific centre of ANS influence was lacking across studies.
Additionally, two studies found significant changes in ANS activity following osteopathic treatments, one involving a larger sample size of 66 subjects and another utilising non-invasive biomarkers in a pilot study.
In conclusion, while the evidence is limited in terms of scope and methodological rigour, there is general support for the effectiveness of osteopathic manipulative treatment (OMT) in influencing ANS function. However, conclusive statements regarding the specific effects of cranial OMT and the influence on sympathetic or parasympathetic nervous systems require further investigation.
Numerous conditions and disorders can impact the autonomic nervous system, specifically the parasympathetic branch of that system.
These include:
Type 2 diabetes: Poorly controlled Type 2 diabetes can lead to damage within the autonomic nervous system, including the parasympathetic division.
Congenital and genetic conditions: These are conditions present at birth, often inherited from one or both parents. Inherited forms of amyloidosis, for instance, can manifest as parasympathetic nervous system dysfunction.
Incontinence: Damage to the nerves controlling bladder and bowel function can result in incontinence, a common consequence of parasympathetic nervous system impairment.
Multiple system atrophy: This progressive disorder, akin to Parkinson's disease, gradually deteriorates autonomic nerves over time.
Sexual dysfunction: Erectile dysfunction is a notable complication in individuals with parasympathetic nervous system damage.
Trauma: Nerve injuries sustained from accidents can have enduring or permanent effects, particularly when involving the spinal cord or major nerve structures impeding or severing parasympathetic connections further downstream.
What are some common signs and symptoms of parasympathetic nervous system dysfunction?
The parasympathetic nervous system orchestrates various bodily functions that occur involuntarily. Consequently, symptoms of dysfunction typically arise when these processes deviate from their normal course.
These symptoms may include:
Constipation
Elevated heart rate (tachycardia) even during periods of rest
Heart rhythm disturbances, such as arrhythmias like atrial fibrillation
Sexual dysfunction
Difficulty digesting food, which may manifest as gastroparesis
Prevention plays a crucial role in safeguarding and preserving the integrity of the parasympathetic nervous system.
Optimal preventive measures encompass:
Maintaining a balanced diet: Adequate intake of essential vitamins, notably vitamin B12, is imperative to prevent nervous system damage. Conversely, excessive vitamin supplementation, particularly vitamin B6, should be avoided due to its neurotoxic potential at high doses.
Avoiding substance abuse: The abuse of drugs and alcohol, particularly through habitual heavy consumption, poses a significant risk of neurotoxicity and harm to the sympathetic nervous system.
Engaging in regular physical activity and maintaining a healthy body weight: The onset and progression of Type 2 diabetes, which can detrimentally affect autonomic nerves, can be mitigated through lifestyle measures aimed at weight management and physical fitness.
Utilising appropriate safety measures: Employing safety equipment, whether in occupational or recreational settings, is paramount for preventing nerve damage resulting from traumatic injuries.
Effectively managing chronic conditions: Individuals with chronic conditions predisposing to nervous system damage should diligently adhere to recommended management strategies. Seeking guidance from healthcare professionals is crucial in optimising disease management and mitigating its impact on overall health and quality of life.
As highlighted previously, osteopathic treatment has shown statistically significant effects in stimulating both the parasympathetic and sympathetic branches of the autonomic nervous system. While further high-quality research with a larger number of participants is warranted in this area, osteopathy emerges as a discipline that holds potential to contribute positively to your journey toward improved health.
Reference list:
Clinic, C., 2022. Parasympathetic Nervous System (PSNS): What It Is & Function. [online] Cleveland Clinic. Available at: <https://my.clevelandclinic.org/health/body/23266-parasympathetic-nervous-system-psns> [Accessed 28 April 2024].
Rechberger, V., Biberschick, M. and Porthun, J., 2019. Effectiveness of an osteopathic treatment on the autonomic nervous system: a systematic review of the literature. European journal of medical research, [online] 24(1). https://doi.org/10.1186/s40001-019-0394-5.
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