Patients with upper respiratory tract infections often come to the office. Some of them are sent to ENT or Phoniatricians and GPs specifically for these disorders, others, perhaps treated for other problems, sometimes show up in the office with laryngitis, pharyngitis, ear infections, sinusitis, rhinitis.
COVID has often offered manifestations of this type, especially in its most recent variants. Many artists on tour or theater productions find themselves having to fight these disorders while having to attend concerts and plays. Primary respiratory tract infections, very frequent in the global population, can often be managed on an outpatient basis. A careful osteopathic evaluation will also allow the treatment of related somatic dysfunctions.
The role of osteopathic manipulative treatment (OMT) can aid recovery by providing relief to symptoms, and restoring the correct structure and function of the respiratory system.
The respiratory system is composed of the oropharynx, which connects the airways, lungs, breathing muscles and chest wall. The nose, mouth, pharynx and larynx comprise the upper airways, connected to the middle ear via the Eustachian tube. Infections in these areas are considered upper respiratory infections. Lower respiratory tract infections include infections that extend from the bronchi to the alveoli.
The upper respiratory tract has the task of humidifying the inspired air, offering protective measures against the entry of microorganisms. Inspiration involves the entry of exogenous microorganisms, dust, gases and fumes into the lungs. For this reason, there must be a filtration system for the removal of harmful material. Cilia and mucus trap incoming microorganisms, while tonsils and adenoids provide an immunological defense against biologically active material.
Smaller particles that escape the trachea and bronchi become trapped in the mucus which is eventually removed by mucociliary transport to the pharynx with subsequent mechanical expulsion through coughing and sneezing. The presence of somatic structural and/or functional dysfunctions in the skull and thorax can hinder our body's defenses against infection.
Because antibiotics are not always indicated or necessary, OMT may fill a possible gap in treatment options in patients.
Respiratory infections are often accompanied by cranial, cervical, laryngopharyngeal and upper thoracic somatic dysfunctions. These dysfunctions contribute to many of the symptoms that accompany upper tract infections and require a thorough osteopathic structural examination in order to complete a comprehensive patient evaluation. By evaluating and treating associated somatic dysfunctions, you can achieve faster and more effective recovery.
The amount of OMT sessions needed to treat various diseases depends on both the patient and the course of the disease.
Upper respiratory tract infections are often associated with coughing or wheezing, resulting in recruitment of the accessory inspiratory muscles: sternocleidomastoid, scalenes, levator scapulae, pectoralis minor, and upper trapezius. These recruitments impact diaphragmatic capacity causing somatic dysfunctions. Treating the first rib (K1) helps to release the anterior scalene, improving the respiratory movement of the rib cage.
Improving the movement of the clavicle helps restore optimal respiratory movement, as it is the insertion point for many muscles involved in respiratory activity. Furthermore, optimizing the movement of the diaphragm and its insertions in L1 and L3, to bring it back to a non-hypertonic state, is of enormous help for a patient with these problems.
The upper ribs (K1-K4), and the related thoracic segment, must be treated to improve respiratory biomechanics. The intercostal muscles may also contract, resulting in shortness of breath.
For patients with localized head and neck disorders, such as sinusitis and otitis media, the skull and cervical spine should be thoroughly examined.
Anatomically, the upper respiratory tract includes the sphenoid, basiocciput, temporal and frontal bones at the cranial level.
Dysfunctions affecting the vagus nerve can affect parasympathetic tone and influence pharyngeal motor activity. There may be retro-orbital and retro-auricular pain from anterior atlas dysfunction in patients with sinusitis or congestion. In these patients, it is important to evaluate the functionality of the frontal and maxilla. This will facilitate the removal of secretions from the maxillary, frontal and ethmoid sinuses. Some membranous techniques can help ear pain secondary to middle ear congestion by mechanically decompressing the ear canal.
All of these regions and related osteopathic maneuvers will improve lymphatic pumps.
To complete the treatment, the Chapman reflex points which contribute to the viscerosomatic reflexes related to primary respiratory infections must be treated.
And you, have you ever turned to an Osteopath to improve these disorders?
Valentina Carlile - Osteopath expert in Osteopathy applied to voice and speech disorders since 2002. For information and reservations visit the page Contacts