Many people know that Osteopaths treat musculoskeletal problems like low back pain, or knee injuries, but we also treat conditions like heartburn.
How an Osteopath can treat a heartburn?- the answer is simple when we understand anatomy and function of diaphragm.
What is Diaphragm?
Diaphragm is a large skeletal muscle situated in lower portion of a rib cage.
It is shaped like a parachute and it is a primary respiration muscle.
What it means is that during inhalation the muscle contracts and flattens downward, lowering pressure in rib cage to draw the air into the lungs and create a space for lungs to expand.
During exhalation the muscle returns to its parachute shape and helps with reduction of volume in rib cage and allows the air to leave the lungs.
Diaphragm muscle has also 3 openings to allow tube like structures to pass through between thoracic and abdominal cavities:
1. Caval Hiatus, where inferior vena cava returns blood from lower part of body towards heart.
2. Aortic hiatus, where aorta and thoracic duct (large lymphatic vessels) passes to abdominal cavity.
3. Oesophageal hiatus, where oesophagus passes to abdominal cavity and then to stomach.
This 3rd opening along with the whole diaphragm muscle tension plays an important role in Heartburn.
So what is Acid Reflux or Heartburn?
Acid Reflux happens when acidic stomach juices leak into the oesophagus and damage its lining often giving burning sensation and/or bitter taste in mouth.
The lower portion of Oesophagus contains a ring shaped muscle called Lower Oesophageal Sphincter, which closes tightly to prevent stomach content from leaking back to Oesophagus.
Diaphragm plays an important role in assisting this muscle in its action.
Around that 3rd opening in Diaphragm where oesophagus passes through, different types of Hiatal Hernias can occur like Sliding Hiatal Hearnia present in 40% of the population (according to Merc Manual Professional) or Paraesophageal Hiatal Hernia.
They can be caused by injury, pregnancy, heavy lifting or other factors.
In some patients they can lead to acid reflux sypmtoms.
Diaphragm is a very strong muscle that continuously contracts and relaxes with every breath and can become hyper-tonic which can also lead to heartburn.
How can Osteopathic treatment help?
Your Osteopath would look at few important things like:
- your symptoms and medical history,
- your breathing pattern (chest or abdominal breathing),
- pain or tenderness around lower ribs and sternum,
- movement of thoracic spine,
- tension of muscles like diaphragm, back muscles or abdominal muscles.
So what does the treatment involve?
That depends on what structures are involved/ restricted.
After evaluation your Osteopath can use variation of different techniques like gentle joint articulation, Soft tissue techniques, muscle energy techniques (MET) or high velocity low amplitude thrust (HVLAT) to improve joint mobility and reduce muscular spasm, which was leading to your symptoms.
You can also be advised on your aftercare at home with heat, cold, stretches or certain exercises when necessary to strengthen the effect of a treatment.