TUCOM-NV
4
Osteopathic Approach in the ER
by Auro Reddy
Chapter National Representative
Recently, one of our very own osteopathic manipulative medicine (OMM) faculty here at Touro University Nevada gave a special presentation on osteopathic principles in the emergency room. Wesley Lockhart, DO, is board certified in emergency medicine and neuromusculoskeletal medicine and offers an uncommon osteopathic modality to ER care.
During his time as a rural ER physician many of the patients he saw on a daily basis were benefited by OMM in conjunction with the existing standard of care. Though not much application can be placed on major trauma, the vast majority of ailments Dr. Lockhart saw were low back pain, muscle spasms, headaches, minor traumatic sprains, etc. Lockhart remarked that there was not much that was being done for these patients apart from remedying the pain and sending the patients on their way. Osteopathic medicine provides a unique approach to the acute minor trauma cases one sees in an emergency room through very specific and yet gentle indirect techniques. Counter strain, MFR, Still technique, and BLT are subtle techniques that further alleviate pain and discomfort when used after a correct diagnosis and medications have been issued. An example is using
counter strain on the piriformis and long restrictors of the hip to release the exacerbation of sciatica pain. Acute
muscles spasms in the cervical region are ideal for Still technique and counter strain on the first rib; there are many similar applications of these techniques that can be used. Dr. Lockhart mentioned the number one complaint in the ER was acute exacerbations of lower back pain. Simply testing and treating the dysfunctions in the long restrictors of the hip, sacrum, and innominate with pain relievers were enough to bring about a significant reduction in pain, increase in range of motion, and importantly a remarkable increase in patient satisfaction. Osteopathic medicine also adds another unique dimension to treatment in the form of fluid management. Dr. Lockhart often used an MFR approach to the cervical thoracic junction in patients with congestive heart failure and angioedema to move fluids, and in the majority of cases saw a noticeable alleviation of symptoms. It is to be noted that careful diagnostics should be used in preparation for any procedure. To Dr. Lockhart, OMM was itself a very useful tool in the diagnosis of minor trauma in the context of his rural emergency clinic, where he was allotted time with his patients.
Dr. Lockhart inspired many of us to understand that osteopathic medicine provides us with unique tools to use alongside modern medicine, which make us adept physicians. ❉