Kate Johnson's Medical Musings

Life through the eyes of a medical journalist

Asthma this Flu Season: How Osteopathy can Help

October 28, 2009

By Kate Johnson.  First published on Your Total Health

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Asthma Alternative: Using Osteopathic Medicine to Gain Control

Is asthma still taking your breath away no matter how carefully you follow your doctor’s orders?

You’re not alone.

While medication is the most effective way of controlling asthma, most asthma patients still go through times when they’re struggling for air.

In fact, some studies suggest that less than a quarter of asthma sufferers actually have their condition under the best control possible.

If medication isn’t adequately addressing the tightness in your chest and stiffness in your lungs, you may still have airway inflammation, which can make your breathing muscles less flexible and more restricted, says Dennis Dowling, D.O., an osteopath in Syosset, N.Y. In order to ease these persistent asthma symptoms, how about adding a mechanical tune-up to your treatment plan?

Like medical doctors, osteopaths (in the U.S.) are fully licensed to prescribe medication and even perform surgery. They work from the premise that the body’s musculoskeletal system plays a central role in illness and, therefore, healing. Using their hands to manipulate the muscles, joints and even internal organs– a technique called osteopathic manipulative medicine (OMT)– osteopaths literally push the body towards healing.

A former professor and chairman of the Osteopathic Manipulative Medicine Department at the New York College of Osteopathic Medicine, Dr. Dowling uses OMT to ease breathing difficulties and calm flares in people with persistent asthma, in addition to their ongoing medical treatment. He says OMT, in combination with drug therapy, can help strengthen asthmatic lungs by loosening stiff muscles and freeing up the ribcage to allow your lungs to take a bigger breath

Montreal osteopath and athletic therapist Dave Campbell demonstrates how this hands-on therapy can improve breathing in someone with asthma. The patient takes a deep breath while Campbell pushes his fingers up and under the ribcage, stretching and loosening the muscles in the diaphragm. He performs a number of other manoeuvers, easing the tension in the intercostal muscles between the ribs, and releasing the scalene and sternocleidomastoid muscles in the neck. All of these things loosen up the ribcage and allow the lungs to inflate more fully. Asthmatic breathing, even without a full asthma attack, overworks these muscles, making them short and tight, and squeezing the ribcage. “By manually easing this tension and getting the patient to fully inflate the lungs, you can help restore efficient respiratory function,” says Campbell. “Ensuring good movement in the cervical and thoracic spine will also help the lungs breathe more effectively and efficiently.”

Some medical doctors remain unconvinced of OMT’s benefits for asthma sufferers, largely because there isn’t a lot of scientific evidence to support the claim. However, one published study of 140 children did show that patients with  persistent symptoms, despite appropriate medical treatment, showed significantly improved lung function when given OMT in addition to their usual medication. ,

Andrea Vianna, M.D. a coauthor of the study, says she has seen OMT dramatically reduce hospitalizations in her asthmatic patients. “Osteopaths have everything that we have as MDs plus this manipulative technique, which is amazing,” she says, from her office in Long Island, N.Y..

So while you continue working with your doctor to fine the best medications for controlling your asthma, you may also consider OMT to help align your muscles to take bigger breaths.


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October 28, 2009 - Posted by | Asthma, H1N1 | , , ,

5 Comments »

  1. Hm. I’m not convinced. I had a look at the trial on which the supposed benefits of osteopathy are based, and it is deeply flawed.

    For one thing, they make the most basic schoolboy error in their statistics. Although they claim it is a sham-controlled trial, they actually make their statistical comparison simply as the change from baseline in the treatment group, and don’t make a statistical comparison with the control group, which rather defeats the point of a controlled trial. For another thing, there was a large imbalance in peak flow between the treatment groups (much greater than the supposed treatment effect!), which makes me suspect that the study was not truly randomised.

    I’m not saying that osteopathy is of no use in asthma, but the osteopaths will need to do better than that if they want to claim an evidence base.

    Still, it’s good to see randomised trials at least being attempted. That’s an improvement on a lot of CAM treatments.

    Comment by Adam | October 29, 2009 | Reply

    • You’re right – the study was not truly randomized – and from my conversations with several osteopaths for this story and also my blog on osteopathy….

      http://katejohnsonmednews.wordpress.com/2009/10/28/asthmatic-lungs-need-extra-care-this-flu-season/

      it seems unlikely the osteopathic community is going to turn its attention towards conducting studies in this, or any other area. Unlike the medical community they are not much concerned about evidence-based practice. All I know, is I can breathe better!

      Comment by katejohnsonmednews | October 29, 2009 | Reply

      • “Unlike the medical community they are not much concerned about evidence-based practice.”

        That’s an interesting point, although I suspect it doesn’t apply to all osteopaths. I’m sure it’s true of many, but do you think it’s true of the overwhelming majority of osteopaths, or is there a significant minority who care deeply about such things?

        I have consulted an osteopath myself for some musculoskeletal stuff (and been quite pleased with the results, although as a statistician I am of course bound to point out that I have no way of knowing whether that was due to the osteopathy or a placebo effect), and have had some fascinating discussions with my osteopath about the evidence base for osteopathy. He’s actually quite good about quoting the evidence base for particular things he does, although this is usually accompanied by a bit of an apology for the poor quality of the evidence!

        I remain fairly sceptical about osteopathy in asthma, although for musculoskeletal conditions I suspect that osteopathy has a great deal to offer (let’s face it, it can’t do much worse than conventional medicine, which has spectacularly little to offer in areas like back pain, other than analgesics). It would be great if we saw more trials done in this area, and I honestly don’t have a good feeling for how much desire there is for that to happen in the osteopathic community. I suspect that, given the high cost of doing trials, we are not going to see very much high quality research unless some kind of statutory framework forces the osteopathy profession into developing an evidence base.

        Comment by Adam | October 30, 2009

      • Precisely. There is no incentive in osteopathy to do high quality studies. I agree that osteopathy has much to offer for musculoskeletal conditions – and I believe asthma is one of those conditions. While airway inflammation has its roots in autoimmunity, or allergy, or other triggers – the results of labored breathing are musculoskeletal problems that further restrict the movement of the ribcage.

        Comment by katejohnsonmednews | October 30, 2009

  2. [...] I recently reported that less than one quarter of asthma sufferers have good control of their condition, which significantly increases their risks for influenza complications. [...]

    Pingback by Asthmatic Lungs Need Extra Care This Flu Season « Kate Johnson's Medical Musings | November 1, 2010 | Reply


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