The AAO Journal, 2024/06, 34(2):10-11. doi: 10.53702/i2375-5717-34.2.7, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/7/500955/LBORC-NUFA-Poster-Abstracts-2024-Clinician-amp)

Keywords:

case report [736]
chronic pain [324]
female [655]
multiple sclerosis [20]
OMT [3925]
osteopathic manipulative treatment [3946]
women [608]

Abstract:

Introduction/Background: Multiple sclerosis (MS) is an autoimmune condition that leads to central nervous system (CNS) inflammation, demyelination, neuronal damage, and gliosis. A multidisciplinary approach to MS management calls for both pharmacological and non-pharmacological approaches. The role of OMT in assisting patients in maximizing functional capacity remains unexplored. Case: A 37-year-old female presented to the Neuromuscular Specialty Clinic earlier this year upon a recent diagnosis of relapsing-remitting MS by her neurologist. The patient has been experiencing symptoms of right-sided weakness and numbness, fatigue, tinnitus, ataxia secondary to neuropathic pain requiring use of a walker, intermittent central scotoma, diplopia, and migraines for the past 3 years. She also presents with severe vitamin D deficiency and supplementation was started. Diagnosis of MS was established based on the 2017 McDonald criteria. Over 8 months, the patient has been receiving Ocrevus (ocrelizumab) infusions (scheduled bi-yearly, patient received her initial 600 mg dose as 2 separate infusions of 300 mg), weekly physical therapy (PT), and monthly OMT. Results: A combination of lymphatic techniques, Chapman’s release to restore autonomic balance, and correction of structural biomechanics were employed. The patient reported significant improvement in her neuropathic pain (10/10 to 5-6/10) and improved Berg Balance Scale (decreased from 30s to 20s range). Discussion: OMT enhances the quality of life in MS patients through better lymphatic drainage slowing disease progression, as well as equilibration of vagal tone, sympathetic trunk tonicity, and craniosacral flow to mitigate sympathetic pain and biomechanical alignment to improve posture and function. Further research should be undertaken to delineate the role of OMT in the control of MS co-morbidities (i.e. transverse myelitis), new MRI lesions, and disability accumulation, so to shed further light on MS management.