Review  |   May 2020
Rhinitis: The Osteopathic Modular Approach
Author Notes
  • From the Department of Pulmonary and Critical Care Medicine at University Hospitals-Cleveland Medical Center in Ohio (Drs Wu and Hostoffer); the University Hospitals-St John Medical Center in Westlake, Ohio (Dr Graven); the Ohio University Heritage College of Osteopathic Medicine in Cleveland (Student Doctor Sergi and Dr Hostoffer); the Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania (Dr Hostoffer); and the Allergy/Immunology Associates, Inc, in Mayfield Heights, Ohio (Dr Hostoffer). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Shan Shan Wu, DO, 5915 Landerbrook Dr, Ste 110, Mayfield Heights, Ohio 44124-4034. Email:
Article Information
Review   |   May 2020
Rhinitis: The Osteopathic Modular Approach
The Journal of the American Osteopathic Association, May 2020, Vol. 120, 351-358. doi:
The Journal of the American Osteopathic Association, May 2020, Vol. 120, 351-358. doi:
Web of Science® Times Cited: 1

Historically, osteopathic principles have focused on the appropriate drainage of cranial structures to relieve symptoms of rhinitis, which include nasal congestion, anterior/posterior rhinorrhea, sneezing, and itching. Allergic rhinitis is primarily an aberrant immunologic reaction caused by cytokines secreted from lymphocytes that traverse the lymphatic pathway throughout the body. Several studies have documented that, when manipulated, the lymphatic system enhanced the motion of these lymphocytes to important immune structures in both human and animal models. Additionally, modulation of both sympathetic and parasympathetic outflow has been found either to inhibit or enhance secretion and/or drainage of important allergic sites. Osteopathic approaches to rhinitis play an effective role in the comprehensive management of rhinitis, and techniques based on these approaches are therapeutic options for rhinitis. This article provides an up-to-date literature review about the management of rhinitis using the 5 models of osteopathic medicine: biomechanical, respiratory-circulatory, metabolic, neurologic, and behavioral.

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