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The Use of Osteopathic Manipulative Treatment (OMT) for Migraines

Osteopathic Manipulative Treatment (OMT) is a hands-on approach used by osteopathic physicians (DOs) to diagnose, treat, and prevent various medical conditions, including migraines. OMT can be particularly beneficial for migraine sufferers by addressing musculoskeletal dysfunctions, improving circulation, and reducing nervous system tension that may contribute to headache onset and severity.

How OMT Helps with Migraines:

1. Addressing Musculoskeletal Dysfunction
   • Many migraine sufferers experience tension and restrictions in the cervical spine (neck), upper back, and cranial bones. OMT techniques help restore normal motion and function in these areas, reducing muscle tightness and joint restrictions that may trigger migraines.
2. Improving Circulation and Lymphatic Drainage
   • Some migraines are associated with vascular changes. OMT can enhance blood flow to the brain and reduce venous congestion, helping to stabilize cerebral circulation. Techniques like venous sinus drainage and suboccipital release can be particularly useful.
3. Regulating the Autonomic Nervous System
   • OMT can help balance sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) nervous system activity, reducing stress-related migraine triggers. Techniques targeting the vagus nerve and cranial-sacral system may help modulate pain perception and autonomic function.
4. Reducing Myofascial and Soft Tissue Tension
   • Myofascial release and soft tissue technique* help relieve tension in the muscles of the head, neck, shoulders, and upper back, which can contribute to migraines. This is especially helpful for patients with cervicogenic headaches or tension-type migraine overlap.
5. Osteopathic Cranial Manipulative Medicine (OCMM) for Migraine Relief
   • OCMM techniques focus on the subtle movement of cranial bones and cerebrospinal fluid dynamics. Many patients report migraine relief with gentle cranial manipulation, which can improve the function of the dura mater (the protective covering around the brain and spinal cord).

Common OMT Techniques for Migraines - Suboccipital Release – Helps release tension in the upper cervical spine, reducing headache frequency and severity. - Venous Sinus Drainage – Enhances circulation and reduces congestion in the head. - Osteopathic Cranial Manipulative Medicine (OCMM)*– Gently mobilizes the cranial bones and dura to relieve pressure and improve nervous system function. - Cervical Spine and Thoracic Manipulation – Addresses vertebral restrictions and improves neck mobility. - Lymphatic Drainage Techniques– Helps reduce inflammation and improve overall circulation. - Myofascial Release– Reduces muscle tightness and fascial restrictions that may contribute to headache pain.

Clinical Evidence and Considerations - Research suggests that OMT can be an effective complementary treatment for migraines, especially for patients who prefer non-pharmacologic approaches or those with medication overuse headaches. - OMT is targeted treatment based on the patient’s specific migraine triggers and musculoskeletal findings. - Safety Considerations: While OMT is generally safe, certain high-velocity, low-amplitude (HVLA) manipulations may not be recommended for patients with vascular disorders or high stroke risk.

Conclusion OMT offers a holistic, non-invasive approach to migraine management, addressing musculoskeletal, neurological, and circulatory factors. By improving cranial mobility, spinal alignment, circulation, and nervous system balance, osteopathic treatment can reduce migraine frequency, duration, and intensity, providing relief for many patients.

During a follow-up appointment, Dr. Keys with address concerns from previous visit as well as evaluate the effects of the treatment on the patients overall wellbeing and physical body. She will also conduce a thorough evaluation and treatment and make additional recommendations related to exercise and lifestyle modifications as needed.

Follow-up appointments are 30-45 minutes and range from $300-$400 depending upon time and body regions treated (cost reduced for pediatric patient). A receipt (superbill) will be sent to the patient to submit to insurance for direct reimbursement.

During an osteopathic doctor’s appointment, patients can expect a comprehensive evaluation that emphasizes the connection between the body’s systems. The physician will conduct a thorough physical examination, including hands-on techniques to assess and treat musculoskeletal issues, while also discussing lifestyle and wellness goals to promote overall health and well-being.

During your initial visit with an osteopath, you can expect the following:

1. Medical History Review: Dr. Keys will ask about your medical history, including any past injuries, surgeries, or chronic conditions. They may also inquire about your lifestyle, occupation, and any current symptoms.

2. Physical Examination: You’ll undergo a physical examination where Dr. Keys will assess your posture, flexibility, and movement. They may check specific areas of concern to evaluate your body mechanics and identify any dysfunction.

3. Diagnosis: Based on your history and examination, Dr. Keys will provide a diagnosis. They will explain their findings and how these relate to your symptoms.

4. Treatment Plan: Dr. Keys will discuss a tailored treatment plan, which may include hands-on techniques to improve mobility, relieve pain, and promote overall health. She may also suggest exercises or lifestyle changes.

5. Treatment Session: Depending on the findings, you might receive your first treatment during this visit. Techniques may include stretching, gentle manipulation, and soft tissue work.

6. Questions and Concerns: You’ll have the opportunity to ask questions about the treatment process and express any concerns you may have.

7. Follow-Up: Dr. Keys will discuss the need for follow-up appointments and what to expect in future sessions.

Overall, the focus will be on understanding your body as a whole and promoting self-healing.

Initial appointments are 50 minutes and range from $400-450 depending upon time and body regions treated (cost reduced for pediatric patient). A receipt (superbill) will be sent to the patient to submit to insurance for direct reimbursement (if patient has out-of-network benefits).

During this visit the pediatric patient will be evaluated and treated with their caregiver. Prior to initial consult, please book a telehealth visit to review important information about the reason for the visit, as well as medical history. I have found it is easier to do this prior to being in the treatment space. Please bring anything that you feel will make the child feel more comfortable during the visit. Some caregivers will bring a toy or snack that they enjoy. My goal is to create and enjoyable and therapeutic experience for the patient.

Osteopathic Manipulative Treatment (OMT) for Prenatal Care

Osteopathic Manipulative Treatment (OMT) is a hands-on, non-invasive approach used by osteopathic physicians (DOs) to support the well-being of pregnant individuals throughout all stages of pregnancy. OMT can help alleviate common musculoskeletal discomforts, improve pelvic and spinal alignment, and enhance overall physiological function, promoting a healthier pregnancy and delivery.

Benefits of OMT During Pregnancy

1. Alleviating Musculoskeletal Pain
   • As the body undergoes hormonal and biomechanical changes, low back pain, sacroiliac dysfunction, pubic symphysis pain, and sciatica are common complaints.
   • OMT techniques such as myofascial release, soft tissue manipulation, and balanced ligamentous tension (BLT) can reduce strain on ligaments, improve mobility, and relieve discomfort.
2. Optimizing Pelvic Function for Labor and Delivery
   • Proper pelvic alignment and sacral mobility are crucial for fetal positioning and an efficient labor process.
   • OMT can help maintain pelvic balance, ensuring the baby has optimal space for positioning and descent during delivery.
3. Improving Circulation and Lymphatic Drainage
   • Pregnancy can lead to fluid retention, swelling (edema), and venous congestion, particularly in the lower extremities.
   • OMT techniques like lymphatic drainage and gentle fascial release enhance fluid movement and reduce swelling.
4. Enhancing Respiratory Function
   • As the uterus expands, it can restrict diaphragmatic movement, making breathing more difficult.
   • OMT can improve rib cage mobility and diaphragm function, promoting better oxygenation for both mother and baby.
5. Reducing Common Pregnancy-Related Symptoms
   • Gastrointestinal discomfor (e.g., acid reflux, constipation)
   • Headaches and migraines (OMT can address musculoskeletal and cranial dysfunctions that contribute to tension headaches)
   • Sleep disturbances and fatigue (by relieving tension and improving nervous system regulation)

Common OMT Techniques for Prenatal Care - Sacral Rocking – Enhances sacral mobility and supports pelvic alignment for delivery. - Myofascial Release – Helps relieve tension in low back, hips, and pelvic ligaments. - Diaphragmatic Release – Improves breathing mechanics and reduces rib cage discomfort. - Lymphatic Drainage Techniques – Alleviate swelling and fluid retention. - Balanced Ligamentous Tension (BLT) – Helps reduce ligament strain as the body adapts to pregnancy. - Gentle Osteopathic Cranial Manipulative Medicine (OCMM) – Can help with headaches, sleep disturbances, and overall relaxation.

Safety Considerations - OMT is generally safe and well-tolerated during pregnancy when performed by a trained osteopathic physician. - High-velocity, low-amplitude (HVLA) techniques and certain positions (e.g., lying flat on the back for extended periods) may need to be modified based on the trimester and patient comfort. - OMT should be used with caution in high-risk pregnancies and always tailored to the individual’s needs.

Conclusion OMT provides a safe, drug-free approach to managing pregnancy-related discomforts, optimizing pelvic and spinal function, and promoting better maternal and fetal well-being. Regular osteopathic care during pregnancy may ease labor and delivery, reduce postpartum recovery time, and enhance overall comfort throughout the prenatal period.

Dr. Keys has had the opportunity to train with Dr. Perrin on multiple occasions and has been treating patients using The Perrin Technique™ successfully now for almost 3 years. She has hosted multiple courses training practioners all over the northeast.

Initial Appointment for The Perrin Technique™ is offered as a package including the following appointments:

Initial Appointment (30 minute tele-health): During this visit Dr. Keys will take a thorough in-depth history including reviewing documents submitted by patient prior to visit (these documents will be sent to patient once they make initial appointment). She will also discuss expectations of the treatment and treatment goals.

First In-Person Visit (45 minutes) During this visit Dr. Keys will do a thorough physical exam, osteopathic structural exam and treatment. In addition, she will demonstrate exercises to be done daily.

First Perrin Technique Treatment (30 minutes): On the second visit Dr. Keys will perform The Perrin Technique™ and demonstrate for the patient self-massage techniques.

Frequency of The Perrin Technique™ is dependent upon the severity of patient symptoms. Most patient require weekly treatments initially and then less frequent with improvement in symptoms. Home exercises and massage are hallmarks of The Perrin Technique™ and will be demonstrated during in-person visits. These exercises are also demonstrated on The Perrin Technique™ website.

The Perrin Technique™, developed by Dr. Raymond Perrin, DO (UK) PhD, is a specialized manual therapy approach primarily aimed at addressing chronic fatigue syndrome (CFS) and related conditions. It is based on the understanding that many chronic illnesses stem from dysfunctions in the body’s lymphatic and immune systems.

Key Elements of The Perrin Technique™:

1. Assessment: The technique begins with a thorough assessment of the patient’s medical history and symptoms. Practitioners evaluate the patient’s posture, movement patterns, and areas of tension to identify underlying issues.

2. Lymphatic Drainage: A central focus of The Perrin Technique™ is improving lymphatic flow. The lymphatic system plays a crucial role in removing toxins and waste from the body. Techniques used may include gentle manipulation to stimulate lymphatic drainage and enhance circulation.

3. Muscle and Fascia Release: The Perrin Technique™ incorporates soft tissue manipulation to release tension in muscles and fascia, promoting relaxation and reducing pain. incorporates soft tissue manipulation to release tension in muscles and fascia, promoting relaxation and reducing pain.

4. Neural Activation: This aspect involves techniques designed to enhance the functioning of the nervous system, improving communication between the brain and body. This can help in reducing fatigue and promoting overall well-being.

5. Holistic Approach: The Perrin Technique™considers the interconnectedness of the body, mind, and spirit. Practitioners may employ lifestyle advice, relaxation techniques, and stress management strategies to support the patient’s overall health.

6. Individualized Treatment: Each treatment plan is tailored to the individual, taking into account their unique symptoms, history, and lifestyle factors.

Overall, The Perrin Technique™ aims to alleviate symptoms, promote recovery, and enhance the quality of life for individuals suffering from chronic conditions, particularly chronic fatigue syndrome and post-COVID syndrome.

During this session we will spend about 15 minutes determining the needs of the patient and best steps to move forward.