Overview of Osteopathic Manipulative Treatment: Suboccipital Release
Acute musculoskeletal pain, or sudden pain in the muscles and bones, is one of the most common complaints in healthcare settings. Patients may receive medication for these complaints, but osteopathic manipulative treatment (OMT), or the manual manipulation of muscles and tissues to reduce pain, is also a useful option. This method helps balance the musculoskeletal system, which is the system that provides form, support, stability, and movement to the body.
Trained doctors can identify issues in the musculoskeletal system by looking for changes in the texture of tissues, asymmetry in spinal alignment, restrictions in joint movement, or tenderness. Certain physical symptoms can give doctors clues about issues elsewhere in the body. For instance, in cholecystitis, an inflammation of the gallbladder, there are typically changes in the spine around the T5-9 region. This is due to irritation from the gallbladder, and understanding these reflexes can help doctors target their treatment.
OMT includes many techniques to address symptoms and restore the body’s natural function. Some techniques are more forceful and require the patient to be actively involved, while others are gentler. The method used depends on the doctor’s experience and the patient’s health status and overall condition. This treatment tends to work better on older patients or patients with other health conditions, with the goal being to allow the body to self-regulate, reduce pain, and improve joint flexibility.
Headaches are a common issue that could benefit from OMT, particularly a technique known as suboccipital release. Tension-type headaches, which are thought to result from pressure on the greater occipital nerve, are commonly treated with anti-inflammatory medications. Migraines, another common type of headache, are often accompanied by nausea, sensitivity to light and noise, and can last up to three days. While medication is commonly used to treat headaches, non-drug therapies, including OMT, can also help reduce patients’ pain. Injecting local anesthetics like lidocaine or bupivacaine into the greater occipital branch of the suboccipital nerve has also been shown to lessen the intensity of acute headaches and increase patient comfort.
Neck pain is another common condition that can be treated with OMT. Most adults will experience neck pain at some point, and this pain can range from musculoskeletal strain or age-related changes in the spine to symptoms of a widespread neurological condition. Several treatments can help with neck pain, including anti-inflammatory drugs, heat, ice, strengthening exercises, and OMT, which provides a non-invasive option.
The suboccipital release technique mentioned previously is particularly helpful for common musculoskeletal complaints like neck pain and headaches. This technique can also help regulate the body’s autonomic system, which controls many of the body’s involuntary functions. This technique can even improve movement and balance in the legs in both healthy individuals and those with pre-existing conditions because it affects the connective tissue along the entire body.
Anatomy and Physiology of Osteopathic Manipulative Treatment: Suboccipital Release
The area at the back of your neck just under your skull is known as the suboccipital region. It is made up of four main muscles: the rectus capitis posterior major, obliquus capitis superior, rectus capitis posterior minor, and obliquus capitis inferior. These muscles are important for helping us support our heads and move our necks.
The top two muscles mentioned, the rectus capitis posterior major and obliquus capitis inferior, are attached at the second bone in the neck (C2). The others, Rectus capitis posterior minor and obliquus capitis superior, are attached to the first bone in the neck (C1). Because of where they’re attached, these muscles help us move our necks back and forth and turn our heads side to side.
There’s also a spot within this muscle group known as the suboccipital triangle. It is formed by the rectus capitis posterior major, rectus capitis posterior minor, and obliquus capitis superior. This spot is significant because it contains a vital artery (the vertebral artery) and the suboccipital nerve, which controls these muscles.
Bigger muscles that support your head and neck, such as the sternocleidomastoid and trapezius, are found on top of the suboccipital triangle. If these muscles get pressed on too hard, it can affect the suboccipital nerve and the vertebral artery, leading to a decrease in blood flow to the area. This, in turn, might give you a stiff neck, headaches, and other discomforts.
It’s worth mentioning that the “myodural bridge,” a connection between these muscles and the covering of the spinal cord (the dura), has been found to contribute to headaches originating from the neck.
Why do People Need Osteopathic Manipulative Treatment: Suboccipital Release
A suboccipital release is a type of treatment that doctors might recommend for several reasons. Generally, it’s used to relieve different forms of discomfort or health problems. These could include the following situations:
If you often experience tension headaches, where you feel a constant ache or pressure around your head, particularly at the temples or back of the head. Or if you suffer from migraine headaches, which are intense headaches causing severe throbbing pain or a pulsing sensation, usually on one side of the head, and often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.
It can also be considered if you have a cervical muscle strain. This is when the muscles in your neck get strained, usually due to posture or activities that keep your neck in the same position for long periods, like working at a computer or driving.
If you often feel uneasy or queasy, known as nausea, or if you’re frequently feeling worried, restless, or nervous, which are symptoms of a state of mind called anxiety, this treatment could also be recommended.
When a Person Should Avoid Osteopathic Manipulative Treatment: Suboccipital Release
Conditions like Tension Headaches or Migraine Headaches might not be treatable or could be severely dangerous if:
- The patient has experienced a recent, sudden break or crack in the bones of their neck, known as an acute cervical fracture.
- There is a worry that blood supply and nerve functionality may have been compromised or impacted in some way – this is referred to as neurovascular compromise.
- There are specific, localized indicators of damage to the nervous system – this is known as a focal neurologic deficit.
Similarly, Neck Pain may also be hard to treat in certain situations:
- If there is a recent, sudden break in the neck bones (acute cervical fractures).
- If there is a worry that blood flow or nerve functions could have been harmed (neurovascular compromise).
Equipment used for Osteopathic Manipulative Treatment: Suboccipital Release
To carry out the suboccipital release technique, a medical method often used to relieve tension in the back of your skull, the following equipment is needed:
- A pillow to ensure your comfort during the procedure.
- An OMT table, which is a special table used specifically for this type of treatment, usually found in an outpatient setting, meaning in a medical facility where surgeries or procedures do not require an overnight stay.
Who is needed to perform Osteopathic Manipulative Treatment: Suboccipital Release?
This is a doctor who has received special training and official approval to practice osteopathic manipulative medicine. In simpler terms, they are doctors who use hands-on techniques to diagnose, treat, and prevent illness by moving and manipulating a patient’s body, especially the muscles and joints. This kind of treatment can often help alleviate pain, restore motion, and support the body’s natural functions to heal itself.
Preparing for Osteopathic Manipulative Treatment: Suboccipital Release
Before a doctor carries out a procedure called a suboccipital release, it’s important to check if there are any existing conditions or health risks that might make the procedure unsafe. This is done through a thorough check of the patient’s neck and upper body, including their nervous system and muscles. Performing these checks is crucial to ensure the procedure doesn’t pose any unnecessary risks to the patient.
If the doctor determines that the procedure is safe to proceed, the patient will lie flat on their back on a bed or examination table. The doctor then positions themselves at the head of the bed by sitting on a stool. They adjust the table to ensure the patient’s head is roughly at the same height as their belly button. This position allows the doctor to work with their arms at a comfortable angle, which is roughly 90 degrees. This proper positioning not only makes the procedure more comfortable for the doctor, but also ensures they can carry out the suboccipital release procedure properly and safely.
How is Osteopathic Manipulative Treatment: Suboccipital Release performed
The suboccipital release is a therapeutic procedure conducted to alleviate tension in specific muscles at the back of the head (suboccipital muscles). It starts with the patient lying flat on their back, facing upwards. A pillow can be used to support the patient’s head, making them more comfortable before starting the process.
During the procedure, the doctor then sits by the head-end of the bed and positions their hands beneath the patient’s head, in the area around the base of the skull, known as the occipital region. The doctor then identifies a line (ridge) on the scalp that marks the lower edge of the bone (occipital ridge).
The doctor then moves their hands a little towards the feet (caudad) until they feel the muscle. Then they push their fingers upwards against these suboccipital muscles. The doctor holds this position for about 3 to 5 minutes or until the muscle tension significantly decreases.
Once the treatment is complete, it’s crucial for the doctor to check again (re-assess) the patient’s symptoms. While some patients may feel a bit tired or still have some symptoms after the procedure, these are usually temporary. Most people notice an improvement in their symptoms following this treatment.
Possible Complications of Osteopathic Manipulative Treatment: Suboccipital Release
A suboccipital release is a typically straightforward and safe medical technique. However, like any medical procedure, it may have some side effects. The most common ones are headaches, tiredness, and feeling like you might throw up. Less frequently, some people might experience increased pain and nerve compression, where pressure is placed on a nerve and can lead to discomfort.
The worst but very rare side effect is something called vertebral artery dissection, which is a tear in the artery in your neck. If this happens, you might feel dizzy, have a headache, and experience neck pain. It’s also possible that the symptoms could start very slowly and subtly, making it hard to notice at first. However, it could also lead to problems with your neurological system, which includes your brain and nerves, shown through physical exams conducted by a doctor.
What Else Should I Know About Osteopathic Manipulative Treatment: Suboccipital Release?
Headaches, neck pain, and other complaints related to the muscles and bones are some of the most common reasons people visit the emergency room or doctor’s office. The first course of treatment usually involves non-prescription pain relievers, applying heat or ice, muscle relaxants, and non-surgical treatments like massage therapy and physiotherapy. Knowing how to perform Osteopathic Manipulative Treatment (OMT) techniques, like the suboccipital release, can offer another solution to patients who require or prefer something other than just medication for their discomfort.
The suboccipital release is straightforward and quick to perform, and it can enhance patient comfort, willingness to comply with treatment, and overall quality of life. It can be especially beneficial for those dealing with acute (sudden or severe) and chronic (long-lasting) muscle and bone pain.
