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Case Reports Suggest Mechanisms for Resolving Concussion Symptoms through Osteopathic Manipulative Treatment

Two case reports published in The Journal of the American Osteopathic Association document improvements in concussion-related symptoms following an initial session of osteopathic manipulative treatment (OMT), according to the American Osteopathic Association.

“OMT has long been an instrumental tool in treating athletes,” said Dr. Naresh Rao, an osteopathic sports medicine physician who will be the team physician for USA Water Polo in Rio de Janeiro for the 2016 Summer Olympics. “With manual techniques including craniosacral therapy, we as osteopathic physicians have the ability to help the body restore the flow of cerebrospinal fluid through the central nervous system to promote healing and get our athletes with concussion-related symptoms back to their normal activities.”

In the first case report, a 27-year-old man was treated three days after a snowboarding accident, in which the patient fell and wasn’t wearing a helmet. He suffered from headache, nausea, dizziness and tinnitus during the days after the fall. After one 25-minute OMT session, the patient reported the dizziness, tinnitus and nausea had resolved and his scores on the Sensory Organization Test (SOT), a computerized measure of balance, improved from 76 before treatment to 81 after treatment.

The second case involved a 16-year old girl with a history of three head injuries, the most recent involving a head-to-head collision. Three weeks after that injury, she reported headache, fatigue, mood swings as well as memory and concentration problems that limited her ability to participate in school and band.

The authors evaluated the girl using the Initial Concussion Symptom Score (CSS), which measures progression of symptoms on a scale of 0 to 144, and the Balanced Error Scoring System (BESS), a 0 to 30 scale measuring vestibular dysfunction. On the day after her first OMT treatment, her CSS decreased from 53 to 22 and her BESS improved from 22 to 17. At the end of six treatments, her CSS was 0 and BESS dropped to 14.

“These cases are consistent with the clinical experiences of osteopathic physicians who use OMT as part of a multidisciplinary approach to concussion,” said Dr. Rao. “While the mechanisms of healing are not well understood with concussion, formal studies measuring OMT’s impact on recovery and quality of life are much needed to demonstrate its efficacy as a viable therapy where there are very limited therapies to date.”

The full case reports are available online:

http://jaoa.org/article.aspx?articleid=2498827

http://jaoa.org/article.aspx?articleid=2498831

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