Duggal Vaibhav, Finkelstein Alexa, Radigan Rachel, Bhushan Priya
Osteopathic Manipulative Medicine, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, USA.
Cureus. 2025 May 15;17(5):e84183. doi: 10.7759/cureus.84183. eCollection 2025 May.
Critical stage lung disease often requires treatment with a lung transplant. This procedure can change the quality of a patient's life, but it does not come without its potential complications. Chronic postoperative pain is one such complication, which is underaddressed and not properly managed. While current management revolves around the use of medications, it is often insufficient. Osteopathic manipulative treatment (OMT) is an additional means of treatment that has been well studied in its ability to address somatic dysfunctions, decrease stiffness, improve respiratory function, and minimize pain. Our 56-year-old patient, who was status-post bilateral lung transplant in 2022, presented to our clinic due to chronic back pain, stiffness, inspiratory pain, and generalized weakness. While her vitals were within normal limits and her general physical exam was benign, her osteopathic structural exam was significant. Alongside thoracic and lumbar restrictions, she presented with hypertonicity of her right latissimus dorsi, serratus anterior, subscapularis, and psoas muscles. She also had articular restrictions of her right ribs. After undergoing OMT for the next five months, the patient continued to report extended bouts of pain relief as well as a decrease in pain with deep inhalation. Her initially reported six out of 10 pain became a consistent two out of 10. She also reported an increase in back strength, a reduction in stiffness, and an overall increase in comfort, allowing her to sleep easily at night. While bringing more attention to chronic postoperative pain, this case demonstrates the efficacy of OMT in becoming an additional part of its management.
重症期肺部疾病通常需要进行肺移植治疗。这一手术可以改变患者的生活质量，但也并非没有潜在并发症。慢性术后疼痛就是这样一种并发症，目前对其关注不足且管理不当。虽然目前的治疗主要围绕药物使用，但往往并不充分。整骨手法治疗（OMT）是另一种治疗方法，在解决躯体功能障碍、减轻僵硬、改善呼吸功能和减轻疼痛方面的能力已得到充分研究。我们的一位56岁患者于2022年接受了双侧肺移植手术，因慢性背痛、僵硬、吸气性疼痛和全身无力前来我们诊所就诊。虽然她的生命体征在正常范围内，全身体格检查也无异常，但她的整骨结构检查结果却很明显。除了胸椎和腰椎受限外，她还表现出右背阔肌、前锯肌、肩胛下肌和腰大肌张力亢进。她的右肋骨也有关节受限。在接下来的五个月里接受整骨手法治疗后，患者持续报告疼痛缓解时间延长，深吸气时疼痛减轻。她最初报告的疼痛评分为十分制中的六分，后来一直稳定在十分制中的两分。她还报告背部力量增强、僵硬感减轻，总体舒适度提高，能够在夜间轻松入睡。在更多关注慢性术后疼痛的同时，这个病例证明了整骨手法治疗作为其管理的额外组成部分的有效性。
