Osteopathic manipulative treatment (OMT) is versatile and particularly suitable for the treatment of low back pain (LBP). The clinical efficacy of OMT regarding pain intensity, functional limitations, quality of life, recovery, and medication consumption in LBP has been confirmed in various studies. These findings were further solidified in a recently published systematic review, leading to an update of US guidelines for the treatment of low back pain. It appears that the positive effects of OMT on pain are related to peripheral parasympathetic anti-inflammatory effects. However, the exact mechanisms of action remain unclear. <\/p>\n
To date, there are few publications dealing with the exact mode of action of OMT using magnetic resonance imaging (MRI). Last year, an Italian research group was able to demonstrate, using functional magnetic resonance imaging (fMRI) and the blood-oxygenation-level-dependent effect (BOLD effect), that an OMT treatment consisting of a total of four sessions has a specific influence on brain areas associated with interoception. Also of interest is the scientific investigation of regional cerebral blood flow (rCBF) using MRI. In 2019, Tamburella et al. demonstrated a modifying effect of OMT on regional cerebral blood flow and suggested that the autonomic nervous system (ANS) could play a central role. This raised the question of what effects OMT has on both the ANS and rCBF. Cerritelli and colleagues addressed this question in a recently published randomized controlled trial by simultaneously measuring regional cerebral blood flow (rCBF) as well as cardiac and respiratory activity. Brain perfusion was determined using the arterial spin labeling (ASL) method. ASL is a non-invasive magnetic resonance imaging method that yields easily reproducible results without the administration of contrast agents. Cardiovascular activities were determined using heart rate variability (HRV), which indicates the adaptability of the human organism’s heart rate to physical and psychological demands. By combining the measurements of HRV and rCBF, the interactions between the brain and heart rate following OMT treatment in patients with chronic low back pain were to be investigated. The following brain regions are activated in chronic pain: <\/p>\n
Interestingly, some of these brain areas are also known as core regions for the central control of the ANS. Cerritelli et al. worked on the hypothesis that OMT (compared to a sham treatment) could cause a decrease in regional cerebral blood flow in the regions of the pain matrix and an increase in parasympathetic activity. To test this hypothesis, 32 patients with chronic low back pain were randomized into an intervention group receiving OMT (n=16) and a control group (n=16), and rCBF and HRV were measured to assess brain-heart interactions. <\/p>\n
At the end of the four-week study (1x OMT per week), patients in the intervention group showed reduced regional cerebral blood flow (rCBF) in several regions belonging to the pain matrix (left posterior insula, left anterior cingulate cortex, left thalamus) as well as in sensory regions, the middle frontal lobe, and the left cuneus. Furthermore, a peripheral autonomic effect was detected, measured by a change in HRV (specifically at high frequencies and the scaling exponent of detrended fluctuation). Particularly noteworthy about the study conducted is that it represents the first experimental evidence for the reciprocal networking reaction between the brain and the heart, and that this reaction can be modulated by OMT. Cerritelli, F., Chiacchiaretta, P., Gambi, F. et al.<\/i> Osteopathy modulates brain\u2013heart interaction in chronic pain patients: an ASL study. Sci Rep<\/i> 11, <\/b>4556 (2021).<\/p>\n","protected":false},"excerpt":{"rendered":"
Osteopathic manipulative treatment (OMT) is versatile and particularly suitable for the treatment of low back pain (LBP). The clinical efficacy of OMT regarding <\/p>\n","protected":false},"author":2,"featured_media":2520,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_seopress_titles_title":"OMT for Back Pain: Effects via the Heart-Brain Axis","_seopress_titles_desc":"How Osteopathic Manipulative Treatment Modulates LBP via the Heart-Brain Axis. Neurophysiological Mechanisms and Clinical Evidence for Practice.","_seopress_robots_index":"","_seopress_robots_follow":"","_seopress_robots_imageindex":"","_seopress_robots_snippet":"","_seopress_robots_primary_cat":"","_seopress_robots_breadcrumbs":"","_seopress_robots_freeze_modified_date":"","_seopress_robots_custom_modified_date":"","_seopress_robots_canonical":"","_seopress_social_fb_title":"","_seopress_social_fb_desc":"","_seopress_social_fb_img":"","_seopress_social_fb_img_attachment_id":0,"_seopress_social_fb_img_width":0,"_seopress_social_fb_img_height":0,"_seopress_social_twitter_title":"","_seopress_social_twitter_desc":"","_seopress_social_twitter_img":"","_seopress_social_twitter_img_attachment_id":0,"_seopress_social_twitter_img_width":0,"_seopress_social_twitter_img_height":0,"_seopress_redirections_value":"","_seopress_redirections_enabled":"","_seopress_redirections_enabled_regex":"","_seopress_redirections_logged_status":"","_seopress_redirections_param":"","_seopress_redirections_type":0,"_seopress_analysis_target_kw":"","_seopress_news_disabled":"","_seopress_video_disabled":"","_seopress_video":[],"_seopress_pro_schemas_manual":[],"_seopress_pro_rich_snippets_disable_all":"","_seopress_pro_rich_snippets_disable":[],"_seopress_pro_schemas":[],"iawp_total_views":0,"footnotes":""},"categories":[106],"tags":[],"themenbereich":[],"class_list":["post-4594","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-osteopathic-research-clinic"],"acf":[],"_links":{"self":[{"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/posts\/4594","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/comments?post=4594"}],"version-history":[{"count":1,"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/posts\/4594\/revisions"}],"predecessor-version":[{"id":5508,"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/posts\/4594\/revisions\/5508"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/media\/2520"}],"wp:attachment":[{"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/media?parent=4594"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/categories?post=4594"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/tags?post=4594"},{"taxonomy":"themenbereich","embeddable":true,"href":"https:\/\/psychosomatic-osteopathy.com\/en\/wp-json\/wp\/v2\/themenbereich?post=4594"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}