What Osteopathic Medicine Has To Offer‘ Golden Girls’

Source: AOA website http://www.Osteopathic.org

by Melicien A. Tettambel, DO

Osteopathic physicians have been trained to appreciate the role of the musculoskeletal system in the maintenance of health. Because physicians understand the reciprocal relationship of structure and function in the health of mature women, they also have opportunities to promote healthy aging.

Female healthcare consumers have been receiving education about menopause, osteoporosis, cancer and chronic disease processes that affect women through support groups, magazines, radio, the Internet, and other telecommunication media. They have been bombarded with information about exercise, nutrition, pharmacotherapy and other therapies.

During well-woman visits physicians offer additional counseling about healthy aging, cancer screening or laboratory evaluation. However, osteopathic physicians can further utilize clinical diagnostic skills of observation and palpation of the musculoskeletal system to positively influence total body function. It also gives physicians the opportunity to address other concerns including hormone therapy.

Physicians need to be prepared to discuss concerns women have about hormone therapy and identify ways to approach women who decide to stop appropriate hormone treatments. In addition, physicians should address these issues and be sensitive to women and the concerns they may have about sexuality. This is even more critical as women become widowed, retired and “empty nesters”. Those who might be considering becoming sexually active again have concerns about vaginal dryness, incontinence, or increased arthritic pain, which interferes with satisfying intimacy. Medications used to treat women for some of these issues may be too expensive or have unpleasant side effects. In addition, some patients may be too depressed to discuss any of these problems.

While it is true that women are twice as likely to be depressed, it is also true that there are many more “mature” women than men living past 70 years of age. They may fear that depression is a sign of senility or part of the aging process–which is incorrect!
Fear of consequences of aging, pain, and depression can create a complicated circuit when it comes to women and wellness. Healthcare professionals have recommended counseling, medication and some physical therapies.

Osteopathic physicians who provide Osteopathic Manipulation Treatments (OMT), stabilize body structure to facilitate physiological function. Therapists may then complement OMT with counseling or other physical therapies.

Evaluating Posture, Breathing
Posture is the result of one’s continuing ordeal with locomotion and gravity. With advancing age there may be spinal changes affecting spinal curves and gait. Weight gain or loss as results of nutrition or activity patterns also affects posture. Women lose height and develop increased thoracic kyphosis with osteoporosis. Arthritic diseases also can cause structural and gait deformities.

Soft-tissue, functional and indirect treatment techniques increase joint range of motion and mobilize tissue fluids to reduce inflammation and edema. The patient may be inclined to articulate other concerns about herself during the course of a treatment. This could be an opportunity to cultivate rapport in developing a treatment plan for other issues.
In addition to evaluating posture (structural health), the osteopathic physician can “read” a patient’s emotional status by observing her respiration and noting changes in tissue tension. Unusually slowed or rapid breathing may convey anxiety or depression. By focusing on the patient’s breathing, an osteopathic physician may also note how the respiratory system might be engaged to maintain general health. Manual treatment of the thorax can influence ones ability to fight infection, metabolize medicines, and reduce inflammation.

It is interesting that breathing may be affected by any or by all of the five most common fatal diseases in women. According to the National Women’s Health Information Center, US Public Health Service Office on Women’s Health, Department of Health and Human Services 1999 Report, 50% of the causes of all 10 leading killers in women include heart disease, cancer, stroke and lung disease.

By encouraging female patients to change poor lifestyle behaviors such as smoking, drinking and inactivity, young women could lower their risk of premature death and disability by as much as 50%.

Thoracic Spine Treatment
Treatment of the thoracic spine with OMT may influence the sympathetic nervous system’s effect on cardiac function. Mobilization of the rib cage may reduce strain of inhalation or exhalation while fighting lung infections. Improved breathing as a result of rib-raising techniques–or lymphatic drainage–aids in dissipating infection.
Altered respiration to encourage slow, deep breathing helps to relieve pain and “breathe away” toxins or drug metabolites. Treatment of the thoracic inlet with OMT decompresses tensions on the vascular and neural contents of the upper thorax to relieve edema. In addition to addressing restrictions of the rib cage, release of respiratory diaphragmatic tension facilitates motion of body fluids and lymphatic drainage.

Women with breast cancer may be treated by lymphatic massage therapists to
reduce incidence of postmastectomy lymphedema. These patients will derive greater benefit from their therapies if they also receive OMT to the thorax, spine and diaphragm.
Osteopathic physicians should keep in mind that treatment of the thorax with OMT may reduce the stress of breathing and congestion, and it may relieve pain. The American Lung Association promotes the slogan, “If you can’t breathe, nothing else matters.”

Treatment utilizing gentle OMT techniques that provide patient comfort is also beneficial in assisting respiration and general metabolism. The patient may be treated frequently and not become exhausted or stressed by vigorous handling of body tissues. Whether in the office or in the hospital, OMT to the thorax need not take more than 10 minutes.

Final Notes
OMT offers “golden girls” pain relief, increased physical mobility, improved metabolism, and antidepressant relief through manual treatment. It may reduce the need to add more pharmaceuticals to a treatment regimen to achieve similar goals of improved circulation, and nerve and joint functions, as well as reduced pain and inflammation. OMT techniques have few side effects or cross-reactivity with medication. They may aid in the promotion of longevity and independent living.

Melicien A. Tettambel, DO, is a member of the AOA’s House of Delegates. She also is a fellow of the AAO and ACOOG. She can be reached by calling (660) 627-1812, by fax at (660) 627-4799 or via e-mail at mtettambel@atsu.edu.