Original Contribution  |   September 2020
Rib Somatic Dysfunction Among General Surgical Patients
Author Notes
  • From the City University of New York School of Medicine in New York (Dr Baltazar); the College of Osteopathic Medicine at New York Institute of Technology in Old Westbury (Dr Baltazar); the Department of Surgery (Drs Baltazar and Kolwitz) and the Department of Osteopathic Manipulative Medicine and Neuromuscular Medicine at St Barnabas Hospital Health System in Bronx, New York (Dr Florek); and the Department of Surgery at New York University Winthrop Hospital in Mineola (Dr Baltazar). 
  • Financial Disclosures: None reported. 
  • Submitted: None reported. 
  •  *Address correspondence to Gerard A. Baltazar, DO, Department of Surgery at New York University Winthrop Hospital, 222 Station Plaza North, Ste 603, Mineola, NY 11501-3893. Email: gerard.baltazar@nyulangone.org
     
Article Information
Neuromusculoskeletal Disorders / Osteopathic Manipulative Treatment
Original Contribution   |   September 2020
Rib Somatic Dysfunction Among General Surgical Patients
The Journal of the American Osteopathic Association, September 2020, Vol. 120, 590-596. doi:https://doi.org/10.7556/jaoa.2020.097
The Journal of the American Osteopathic Association, September 2020, Vol. 120, 590-596. doi:https://doi.org/10.7556/jaoa.2020.097
Abstract

Context: 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).

Objective: To describe rib SD in the GS setting and help build a foundation for additional osteopathic manipulative treatment (OMT) research in surgical care.

Methods: 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.

Results: 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.

Conclusions: Rib somatic dysfunction may contribute to patient referral to a GS service, and OMT performed by general surgeons may help provide optimal surgical care.

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