Osteopathic Manipulative Treatment: Muscle Energy Procedure - Cervical Vertebrae

Dr. Fred Mitchell Sr. worked out the motions of the pelvis in the 1950s, and using this knowledge, he began to treat dysfunctions using muscle action. This style of treatment was named muscle energy technique, or MET. Muscle energy is a direct technique that the dysfunctional muscle actively engages during treatment, and it is now a well-established osteopathic technique used to address a variety of somatic dysfunctions. Somatic dysfunctions are defined as changes to the structure and function of the somatic system, composed of muscle, fascia, nerves, and vasculature. In the cervical region, this typically presents as "increased muscle tension, sensitivity changes, asymmetry, and restriction of range of motion." There are multiple physiologic principles to muscle energy. These include crossed, extensor reflex, isolytic lengthening, isokinetic strengthening, joint mobilization, respiratory assistance, oculocephalic reflex, reciprocal inhibition, post-isometric relaxation, and muscle force in one body region to achieve movement in another. Out of these 10, post-isometric relaxation is the most commonly utilized. Osteopathic physicians typically use the muscle energy technique (MET) to correct somatic dysfunction that causes pain and discomfort, especially in but not limited to the thoracic spine. Neck pain is a common presenting symptom affecting approximately 15% of males and 23% of females. The etiology of neck pain can include poor posture, recent or past trauma or surgery, stenosis, malignancy, and neuropathy. However, the cause is usually mechanical. Manual and exercise therapy often treats neck pain arising from mechanical issues. This activity discusses an osteopathic manual approach to treating neck pain.