Pericardial Adhesion and Chronic Non-Specific Neck Pain following Thoracentesis: An Osteopathic Approach

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death globally. Morbidity and disability related to non-fatal events are increasing exponentially. There are several symptoms that may arise after invasive therapeutic approaches such as coronary artery bypass graft (CABG), including chronic pain in anatomical areas connected to the mediastinum; these pains can be found not only initially after surgery but also years later. We present a case where non-specific neck pain (NNP), in a patient undergoing CABG five years earlier, was resolved with an osteopathic technique, working the pericardial area. To the knowledge of the authors, it is the first article illustrating an osteopathic approach with resolution of NNP, with a manual technique used on the pericardial area.

Proposal for Manual Osteopathic Treatment of the Phrenic Nerve

“…OM bases its manual approach on various techniques, including gentle "listening" techniques, where the clinician does not induce any movement [ 59 ]. The operator places his fingers or hand on the tissue chosen for the treatment; once the tissue is contacted, the pressure does not increase, and the perceived tissue tension does not change [ 59 ]. Imagine placing your fingers on a rose petal; no pressure is needed to evaluate the consistency of the flower.…”

“…Imagine placing your fingers on a rose petal; no pressure is needed to evaluate the consistency of the flower. The listening technique ends when the tension of the worked tissue changes positively: the tension is reduced or the movement expressed by the palpated tissue is homogeneous [ 58 , 59 ].…”