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Vol.6 , No. 3, Publication Date: Jul. 4, 2019, Page: 17-22
. This case involves a 35 year-old active duty U.S. Army Sergeant with six combat deployments to Afghanistan, who underwent a right lower extremity, below the knee amputation during July 2017. The patient underwent osteopathic manual manipulation therapy as treatment and management of his extensive PLP. Two weeks post-operatively, the patient experienced excruciating PLP. Cranial Rhythmic Impulse (CRI) was noted as a palpable symmetric wave form in normal tissue. When the patient’s PLP initially began, the primary practitioner was curious as to how the amputation might have affected the CRI through the residual limb, and whether these changes could be manipulated to decrease the patient’s perceived PLP. The impulse was stronger on the medial side when compared to the lateral side, and the impulses differed in timing when comparing right to left. The patient immediately experienced relief from his PLP to the point of falling asleep during the session. Due to the patient’s perceived success of this first session, the technique was repeated several times over the next eight weeks. Even when considering the inherent confounding factors and bias in this case report, the patient did experience immediately relief from his over eight weeks. This factor alone demands that OMM, OMT and OCMM techniques be further investigated for PLP as a treatment modality. The best services to support military and veteran amputees, as well as other non-military amputees, would be to have available low cost and low risk treatment and management solutions.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | Danyel Roxanne Baker, Edward Via College of Osteopathic Medicine, 2265 Kraft Drive, Blacksburg, Virginia, USA. |
| [2] | James Robert Palmieri, Edward Via College of Osteopathic Medicine, 2265 Kraft Drive, Blacksburg, Virginia, USA. |
| [3] | David Gardner Harden, Edward Via College of Osteopathic Medicine, 2265 Kraft Drive, Blacksburg, Virginia, USA. |
| [4] | Stephen Douglas Blood, Edward Via College of Osteopathic Medicine, 2265 Kraft Drive, Blacksburg, Virginia, USA. |
| [5] | Michael Richard Mabry, Edward Via College of Osteopathic Medicine, 2265 Kraft Drive, Blacksburg, Virginia, USA. |
| [6] | Benjamin Thomas Canipe, Edward Via College of Osteopathic Medicine, 2265 Kraft Drive, Blacksburg, Virginia, USA. |
| [7] | Wallie Martínez-Vega, Edward Via College of Osteopathic Medicine, 2265 Kraft Drive, Blacksburg, Virginia, USA. |
Amputation of a lower limb is a stressful experience for any amputee and requires physical, psychological and social adjustments. Since the start of the Iraq war in 2003, military troop personnel have suffered blast injuries, most were attributed to ground-placed IEDs or land-mines. An emerging pattern of high, multiple extremity amputations have established on the battlefield, involving the lower limbs. There are numerous approaches for the treatment and management of Phantom limb pain (PLP). This case involves a 35 year-old active duty U.S. Army Sergeant with six combat deployments to Afghanistan, who underwent a right lower extremity, below the knee amputation during July 2017. The patient underwent osteopathic manual manipulation therapy as treatment and management of his extensive PLP. Two weeks post-operatively, the patient experienced excruciating PLP. Cranial Rhythmic Impulse (CRI) was noted as a palpable symmetric wave form in normal tissue. When the patient’s PLP initially began, the primary practitioner was curious as to how the amputation might have affected the CRI through the residual limb, and whether these changes could be manipulated to decrease the patient’s perceived PLP. The impulse was stronger on the medial side when compared to the lateral side, and the impulses differed in timing when comparing right to left. The patient immediately experienced relief from his PLP to the point of falling asleep during the session. Due to the patient’s perceived success of this first session, the technique was repeated several times over the next eight weeks. Even when considering the inherent confounding factors and bias in this case report, the patient did experience immediately relief from his over eight weeks. This factor alone demands that OMM, OMT and OCMM techniques be further investigated for PLP as a treatment modality. The best services to support military and veteran amputees, as well as other non-military amputees, would be to have available low cost and low risk treatment and management solutions.
Keywords
Amputee, Cranial Osteopathy, Craniosacral Technique, Indirect Myofascial Technique, Indirect Technique Military Amputee, Osteopathic Manipulative Medicine (OMM), Osteopathic Manipulative Treatment (OMT), Phantom Pain
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