Efficacy of Myofascial Unwinding and Myofascial Release Technique in a Patient with Somatic Symptoms, A Case Report

Participants

• Number: 1
• Description: 39-year-old woman, housemaker, with a diagnosis of dysthymia and moderate depression with somatic symptoms. She presented with a complaint of negative mood, loss of interest in daily activities, palpitations, fatigability, decreased appetite, insomnia (specifically, inability to fall asleep again when awakened during the night), body aches and listlessness for the past three years. Her medical and chirurgical history did not show anything in particular, and neither did the blood tests (within normal range).

The patient was treated pharmacologically (mirtazapine, clonazepam, proton pump inhibitors and non steroidal anti inflammatories) but without significant results. The osteopathic examination showed restricted motion at the level of lambdoidal and sagittal sutures, at the sacral base, and at the dural and diaphragmatic levels. Also the neck and trunk showed tenderness and restricted motion.

Interventions and evaluations

• Evaluation of the level of depression on HDRS and of quality of life through Q-LES-Q-SF at the first visit and 6 weeks after the intervention
• 3 weekly OMT sessions of 20 minutes for 4 weeks
• OMT: myofascial release technique directed at the different diaphragms, at the cervical fascia, at the occipitoatlantal region and at the sacrum; myofascial unwinding directed at the cranium
• Pharmacologic prescription of opipramol and etizolam

Results

6 weeks after the end of the OMT, the level of depression measured on HDRS decreased, as well as the quality of life measured through Q-LES-Q-SF improved. Consequently the pharmacologic therapy dosage was lowered.

Discussion

OMT, in combination with a pharmacologic therapy, showed to be able to produce positive effects in case of depression with connected somatic symptoms. The reason for the effect of OMT may lie in the fact that, through the stimulation of the fascial mechanisms, on the one hand it can induce a relaxation of the fascia, thus inducing less pain, on the other hand it can reduce a hyper-activation of the stress axis and autonomic nervous system, reducing the secretion of cortisol and promoting that of relaxing neurotransmitters.