Abstract
This is a case of a 73-year-old female with achalasia, hiatal hernia, and prior failed laparoscopic Heller myotomy with Dor fundoplication suffering from severe gastroesophageal disease. The patient developed debilitating neck pain associated with her severe gastroesophageal reflux disease (GERD). She underwent a comprehensive musculoskeletal workup that included a cervical computed tomography (CT) scan and magnetic resonance imaging (MRI). The radiologic imaging results proved unremarkable for identifying the cause of her neck pain. Pain management, neurology, and neurosurgery consultations were unable to provide an etiology that explained her symptoms. Searching for methods of treatment to relieve her neck pain, she received osteopathic manipulative treatment (OMT) focused on somatic dysfunction of both the musculoskeletal system and viscera. The results of osteopathic treatment significantly improved her symptoms. Although OMT provided temporary relief of her neck pain, her GERD symptoms persisted and her neck pain gradually returned. Since a comprehensive workup for neck pain revealed no etiology and she had positive responses to OMT, including treatments focused on the viscera, we attributed her neck pain to a viscerosomatic response of gastrointestinal disease. This case report demonstrates the benefit that osteopathic manipulative treatment provides in diagnosis and treatment of uncommon causes of neck pain such as that resulting from viscerosomatic reflexes. Identifying viscerosomatic reflexes can broaden differential diagnoses and lead to better patient care.
Assessment of shoulder pain and somatic dysfunction in young competitive swimmers: Preventive Osteopathic Manipulative Treatment