An innovative approach to treating lymphatic associated pathologies using Osteopathic spinal manipulations

The manual lymphatic pump technique is acknowledged to be effective in the treatment of lymphoedema. The question is raised as to whether other manual techniques (such as 'spinal manipulations') can be used to achieve changes in lymphatic dynamics.
Various manual therapists utilise techniques that are classified as 'manipulative'. Although the fine details vary between the professions (for example Osteopaths use "High Velocity Low Amplitude" (HVLA) thrusts) the general premise is to use an operator directed thrust technique to achieve a cavitation (audible popping noise) in the prescribed joint of the patient. These manipulative techniques are associated with improved joint ranges of motion, altered biomechanics, neurological changes and the release of chemical messengers. As the cysterna chyli is primarily innervated via the 11th thoracic ganglion, it is hypothesised that a manipulation in this region of the thoracic spine may result in localised increases in sympathetic tone, causing enhanced pumping of the lymphatic tissues and resulting in an increase in local and systemic lymphatic flow. The current work therefore aims to establish whether an Osteopathic HVLA thrust technique to the thoracic region has any influence on the lymphatic flow through the cysterna chyli. For the initial study a cohort of healthy volunteers are to be recruited. Each person will be assessed pre and post intervention to establish if any changes in their physiological parameters are demonstrated as a result of the Osteopathic intervention. The physiological parameters and body composition will be measured using the INBody 3.0 and the Impedimed LU400 in the Department of Surgery, Lymphoedema Assessment Unit, Flinders Medical Centre, Australia.
The paper will present the results from the study as well as exploring the potential mechanisms of action for the intervention. Based on the results it will be possible to establish whether an Osteopathic HVLA thrust technique to the thoracic region provides an innovative adjunct and/or alternative treatment modality for enhancing lymphatic flow through the cysterna chyli. If the provisional study demonstrates suitable outcomes in the healthy volunteers then it will be repeated in those with clinically manifest lymphoedema of the legs and lower body.