Osteopathic Manipulative Treatment: Muscle Energy Procedure - Lumbar Vertebrae

Low back pain represents one of the most prevalent ailments in contemporary society. Statistics indicate that around 90% of individuals will encounter acute back pain at some point in their lives, with approximately 10% experiencing chronic low back pain. The multifactorial nature of low back pain often makes its origins complex, with only about 15% of cases attributed to known causes, leaving the remaining 85% with unknown etiologies. This condition not only induces physical discomfort but also impacts patients psychologically, contributing to feelings of depression and anxiety. Addressing spinal pain remains a significant challenge for healthcare providers worldwide. However, the muscle energy technique (MET) presents a promising treatment approach. By manipulating various components of the spine, including vertebrae, intervertebral discs, spinal ligaments, and associated muscles, MET offers a means to significantly alleviate both acute and chronic low back pain.  Dr. Fred Mitchell, Sr. initially developed the MET in the 1950s. This technique is considered a direct, active treatment. In MET, the patient is frequently positioned toward the barrier, and the patient will move to produce an activating force. There are 9 physiological principles to muscle energy—post-isometric relaxation, respiratory assist, joint mobilization using muscle force, oculocephalic reflex, reciprocal inhibition, crossed extensor reflex, isokinetic strengthening, isolytic lengthening, and muscle force in one region of the body to achieve movement in another. Among these, post-isometric isolation is the most commonly utilized method. In this technique, the patient is positioned toward the barrier and instructed to apply an activating force toward freedom. The resulting isometric contraction induces reciprocal inhibition and relaxation of antagonistic muscles, effectively addressing soft tissue restrictive barriers and promoting joint mobilization. This process ultimately leads to pain reduction and improved circulation.  MET is an important tool for trained professionals in addressing low back pain, which is particularly crucial due to the marked potential abuse of opioid medications. Opioids do not address the underlying somatic dysfunction causing low back pain and serve only to mask pain. MET reduces pain by addressing the root of the problem, which is the misalignment and inappropriate proprioception of the spine, surrounding musculature, and other associated soft tissues. MET realigns spinal segments and relaxes musculature and associated soft tissues by delicately restoring spinal segments to their anatomical alignment through the body's muscular system. This procedure enhances the flexibility of muscles, fascia, and joints, leading to decreased pain, improved circulation, and enhanced lymphatic drainage in the treated region. Misalignment of the lumbar spine and its associated spinal tissues is a recognized contributor to nonspecific low back pain. However, through osteopathic evaluation of the lumbar spine, clinicians can pinpoint specific dysfunctions and effectively alleviate the associated pain.