Osteopathic treatment for asthma began in the 1870s and has targeted 3 areas: addressing somatic dysfunction of thoracic spine and ribs, improving diaphragmatic function, and balancing sympathetic and parasympathetic dysregulation.
19-24 Patients with asthma have multiple systems involved in the inherent pathophysiology of their disease: biomechanical, metabolic, respiratory/circulatory, musculoskeletal, and behavioral. Early 20
th-century discussions by Moore
21 and Oium,
22 a 1993 editorial by Allen and D'Alonzo,
23 a 1996 clinical practice guide by Paul and Buser,
24 1999 literature reviews by W.A. and M.P. Rowane
19 and Jackson and Steele,
20 a 2004 review by Salamon,
25 and a 2013 systemic review of randomized control trials (RCTs) by Piosadski et al
26 are among the limited osteopathic literature describing the pathogenesis and osteopathic treatment of asthma.
27-30 Other studies have provided evidence of the benefit of osteopathic manipulative treatment (OMT) through pilot studies
31-32 and a pediatric randomized clinical trials (RCTs),
26,28,30 as well as evidence regarding other nonpharmacologic therapies, such as acupuncture and chiropractic manipulation,
30,33-35 in asthma management. No animal models, nor any expansive clinical studies or RCTs, exist in the literature to further support recommendations for these adjunctive therapies. Here, we present an updated review of asthma, its pharmacologic treatments, and the most common and effective OMT techniques for managing this chronic lung disease.