View source for Somatic dysfunction

{{fringe theories|date=September 2018}}
{{Medref|date=September 2013}}
In [[Osteopathic medicine in the United States|osteopathic medicine]] and [[osteopathy]], '''somatic dysfunction''' is defined as the impaired or altered function of related components of the somatic (bodywork) system including: the skeletal, [[arthrodial]], and [[myofascial]] structures, and their related vascular, lymphatic, and neural elements. Somatic dysfunction may be evaluated and treated by osteopaths or [[osteopathic physician]]s using [[osteopathic manipulative medicine|osteopathic manual technique (OMT)]].<ref>{{Cite journal|last1=Barnes|first1=PL|last2=Laboy 3rd|first2=F |last3=Noto-Bell|first3=L|last4=Ferencz|first4=V|last5=Nelson|first5=J|last6=Kuchera|first6=ML|title=A comparative study of cervical hysteresis characteristics after various osteopathic manipulative treatment (OMT) modalities.|journal=Journal of bodywork and movement therapies |volume=17 |issue=1 |pages=89–94 |year=2013 |pmid=23294689 | doi =10.1016/j.jbmt.2012.10.004}}</ref>

==Diagnosis==
Somatic dysfunction is diagnosed via physical examination by an osteopathic physician, who is a physician with the [[Doctor of Osteopathic Medicine]] degree (D.O.). The osteopathic physician looks for [[Medical sign|signs]] and [[symptom]]s related to the somatic dysfunction commonly represented by the [[mnemonic device]] "TART" ('''t'''issue texture change, '''a'''symmetry, '''r'''estriction, and '''t'''enderness) or "STAR" ('''s'''ensitivity, '''t'''issue texture change, '''a'''symmetry, '''r'''estriction).<ref name=Savarese_1-3>{{Harvnb|Savarese|Capobianco|Cox|2009|pp=1–3}}</ref> The physician uses techniques such as layer-by-layer palpation and intersegmental range of motion testing to diagnose the somatic dysfunction. Diagnosis usually requires only the use of the physician's hands and fingertips, though instruments such as a [[goniometer]] can be used to detect a diminished range of motion.

==Signs and symptoms==
Tissue texture changes may include [[edema]], [[fibrosis]], [[atrophy]], rigidity, or hypertonicity of musculature.<ref name=Savarese_1-3 /> There may be asymmetry in the bones, muscles, or joints.<ref name=Savarese_1-3 /> There may also be a "restrictive barrier" related to the musculoskeletal structure in question. The language of "barriers" refers to the point at which a structure cannot move farther in a given direction. For example, a natural "physiologic barrier" of the arm represents the farthest that a person can naturally move their arm before it cannot be comfortably moved farther. The "anatomic barrier" describes how far the arm can be pushed or pulled by an outside force before the arm becomes physically injured. A "pathological" or "restrictive" barrier represents the shortened range of motion to which the arm is confined because of an injury, muscle spasm, or some other somatic dysfunction. The goal of treatment is to restore the arm's full range of motion (or that of the structure in question). Of the signs and symptoms associated with somatic dysfunction, tenderness is the only purely subjective finding, while the others are objective findings.<ref name=Savarese_1-3 />

==Types of somatic dysfunction==
Other types of somatic dysfunctions may include occlusions or mutilations of vasculature or lymphatic vessels, which can impair [[cardiovascular system|cardiovascular]] or [[lymphatic system|lymphatic circulation]].{{medcn|date=September 2018}} This may also occur secondary to organ pathology, a factor which theoretically allows the detection of visceral dysfunction by examining surface structures.{{medcn|date=August 2010}} It is by this explanation that [[chapman reflex points|Chapman's Points]] are said{{by whom|date=September 2018}} to be used in identifying problems with deep tissue structures{{medcn|date=September 2018}}. A [[chapman reflex points|Chapman's Point]] is an area of bunched tissue or vasculature that osteopaths assume to occur as a result of fluid backup or another dysfunction at a portion of the vasculature more proximal to an organ affected by pathology.<ref name=Glossary>{{cite web|title=Glossary of Osteopathic Terminology|url=http://www.aacom.org/resources/bookstore/Documents/GOT2011ed.pdf|publisher=American Association of Colleges of Osteopathic Medicine|page=10|date=April 2009|accessdate=25 August 2012|archive-date=2 October 2013|archive-url=https://web.archive.org/web/20131002131413/http://www.aacom.org/resources/bookstore/Documents/GOT2011ed.pdf|dead-url=yes}}</ref> The evidence for these points remains controversial, though some studies suggest modest sensitivity and specificity for their use in diagnosis.<ref>{{cite journal|last=Washington|first=K|author2=Mosiello, R|author3=Venditto, M|author4=Simelaro, J|author5=Coughlin, P|author6=Crow, WT|author7=Nicholas, A|title=Presence of Chapman reflex points in hospitalized patients with pneumonia.|journal=The Journal of the American Osteopathic Association|date=October 2003|volume=103|issue=10|pages=479–83|pmid=14620082|url=http://www.jaoa.org/content/103/10/479.long|accessdate=7 December 2012}}{{dead link|date=March 2018 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>{{medrs|date=September 2018}}

==See also==
* [[Fryette's laws]]

== References ==
{{Reflist}}

===Additional sources===
*{{cite book |author=Ward, Robert |title=Foundations for Osteopathic Medicine |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2003 |edition=2nd |pages= |isbn=0-7817-3497-5 |oclc= |doi= |accessdate=}}
*{{cite book|last1=Savarese|first1=Robert G.|last2=Capobianco|first2=John D.|last3=Cox|first3=James J.|title=OMT review|year=2009|publisher=|isbn=978-0967009018|ref=harv}}

{{Osteopathic medicine3}}

{{DEFAULTSORT:Somatic Dysfunction}}
[[Category:Osteopathic medicine]]
[[Category:Manual therapy]]
[[Category:Osteopathic manipulative medicine]]
[[Category:Somatic psychology]]
{{Source Wikipedia}}