Baltazar GA, Kolwitz CE, Florek MG. Rib Somatic Dysfunction Among General Surgical Patients. J Am Osteopath Assoc 2020;120(9):590–596. doi: https://doi.org/10.7556/jaoa.2020.097.
Download citation file:
Upper abdominal or chest pain, tenderness, or sensation of the presence of a mass may lead to general surgery (GS) service referral. These symptoms may be related to rib somatic dysfunction (SD).
To describe rib SD in the GS setting and help build a foundation for additional osteopathic manipulative treatment (OMT) research in surgical care.
The authors retrospectively reviewed and analyzed the electronic medical records of patient encounters in a GS outpatient clinic or private office in Bronx, New York. Included patients had emergency department or inpatient GS consultations with the diagnosis of rib SD (ICD-9 739.8 or ICD-10 M99.08) initially made by the GS service from February 1, 2016, to January 31, 2019. Six-month follow-up data were also reviewed.
Twelve patients had rib SD as the underlying cause of their chief concern upon presentation to the GS service. Only 1 also had an underlying operative GS disease. The GS service treated 11 patients (91.7%) with OMT; 1 patient refused OMT. Time spent on OMT ranged from 5 to 30 minutes, with a median of 10 minutes and a mean (SD) of 12.7 (9.05) minutes. The OMT techniques used included balanced ligamentous tension, counterstrain, muscle energy, myofascial release, rib-raising, and soft tissue. All patients who received OMT demonstrated improvement, and 3 patients required osteopathic manipulative medicine/neuromuscular medicine follow-up.
Rib somatic dysfunction may contribute to patient referral to a GS service, and OMT performed by general surgeons may help provide optimal surgical care.
Abbreviations: AROM, active range of motion; APAP, acetaminophen; CAP, chest/abdomen/pelvis; CLINIC, hospital service clinic; CT, computed tomography; CXR, chest roentgenogram; ED, emergency department consultation; ERCP, endoscopic retrograde cholangiopancreatography; GS, general surgery; INPATIENT, inpatient consultation; LUQ, left upper quadrant; OFFICE, private office; P&T, pain and tenderness; RUQ, right upper quadrant; US, ultrasonography; VATS, video-assisted thorascopic surgery.
Abbreviations: BLT, balanced ligamentous tension; COPD, chronic obstructive pulmonary disease; CS, counterstrain; ME, muscle energy; MFR, myofascial release; OMM/NMM, osteopathic manipulative medicine/neuromusculoskeletal medicine; OMT, osteopathic manipulative treatment; RR, rib-raising; ST, soft tissue; SD, somatic dysfunction.
This PDF is available to Subscribers Only
View Article Abstract & Purchase Options