Asthma and respiratory tract infections

Osteopathic treatment plays a significant role in the maintenance of the musculoskeletal system involved in respiration and circulation.

Osteopathic treatment can help patients with pulmonary complaints by:

  • improving the venous and lymphatic flow
  • improving arterial circulation to carry immune system cells to the lungs
  • ease removal of mucus and phlegm
  • optimising the breathing process by working on the thoracic cage, spine, collar bone and sternum
  • maximise the patient's potential for health


Asthma is a common respiratory disorder resulting from increased sensitivity of the airways to varied stimuli such as allergens, exercise, irritants such as strong odors or emotion. In an acute attack, it is essential to use medication and keep hydrated. Once the respiration settles down, osteopathy can be useful in assisting the patient to breathe better and loosening any mucus.  Between acute attacks, osteopathic treatment can be used to prevent any abnormal feedback to the lungs (the nerve supply to the lungs come from the thoracic vertebrae, so when the lungs are irritated, this can lead to vetebral dysfunctions. If this is not treated, this can create a reflex feedback to the lungs and irritate it, without an asthma trigger). Moreover, osteopathic treatment can be a calming therapeutic factor.

Pneumonia and respiratory tract infections

During the outbreak of Spanish flu in 1918, osteopathic treatment helped reduced the mortality rate and risk of developing pneumonia. For respiratory tract infections, osteopathy can also reduce the need for antibiotics, hospital stay and boost the immune system.


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Guiney PA, Chou R, Vianna A, Lovenheim J

Published in the J Am Osteopath Assoc Jan;105(1):7-12 2005

OMT group showed a statistically significant improvement of 7 L per minute to 9 L per minute for peak expiratory flow rates. These results suggest that OMT has a therapeutic effect among this patient population. The authors suggest that more clinical trials are required to better demonstrate the effectiveness of OMT in patients with asthma.

Pepino VC, Ribeiro JD, Ribeiro MA, de Noronha M, Mezzacappa MA, Schivinski CI.

Published in the J Manipulative Physiol Ther Jan;36(1):57-65 2013

The use of manual techniques on children with respiratory diseases seems to be beneficial. Chiropractic, osteopathic medicine, and massage are the most common interventions. The lack of standardized procedures and limited variety of methods used evidenced the need for more studies on the subject.

Mehl-Madrona L, Kligler B, Silverman S, Lynton H, Merrell W

Published in Explore (NY) Jan-Feb;3(1):28-36. 2007

Acupuncture and/or craniosacral therapy are potentially useful adjuncts to the conventional care of adults with asthma, but the combination of the two does not provide additional benefit over each therapy alone.

Bockenhauer SE, Julliard KN, Lo KS, Huang E, Sheth AM

Published in the J Am Osteopath Assoc Jul;102(7):371-5; discussion 375 2002

Measurements of both upper thoracic and lower thoracic forced respiratory excursion statistically increased after osteopathic manipulative procedures compared with sham procedures. Changes in peak expiratory flow rates and asthma symptoms were not statistically significant.

Lee-Wong M, Karagic M, Gomez S, Wilson A, Resnick D

Published in The Internet Journal of Asthma, Allergy and Immunology 7:2 2008

Patients treated for acute asthma exacerbation with nebulizer treatment followed by osteopathic treatment (rib raising maneuver) showed significant improvement in their overall breathing. Unfortunately, lack of a control group in which there would be nebulizer treatment plus no osteopathic treatment makes it uncertain whether this OMT treatment had more than a placebo effect. However, since more patients request alternative therapies more research in OMT techniques should be considered. Offering osteopathic treatments as adjunct to traditional asthma treatment in an acute setting appears to have no adverse effects and may have psychological benefits.

Noll DR, Degenhardt BF, Morley TF, Blais FX, Hortos KA, Hensel K, Johnson JC, Pasta DJ, Stoll ST.

Published in the Osteopath Med Prim Care Mar 19;4:2 2010

ITT analysis found no differences between groups. PP analysis found significant reductions in LOS, duration of intravenous antibiotics, and respiratory failure or death when OMT was compared to CCO. Given the prevalence of pneumonia, adjunctive OMT merits further study.

Saggio G, Docimo S, Pilc J, Norton J, Gilliar W.

Published in the J Am Osteopath Assoc Mar;111(3):143-7 2011

This study demonstrates the positive effect of OMT on sIgA levels in persons experiencing high stress. Results suggest that OMT may then have therapeutic preventive and protective effects on both healthy and hospitalized patients, especially those experiencing high levels of emotional or physiological stress and those at higher risk of acquiring upper respiratory tract infections.


Creasy C, Schander A, Orlowski A, Hodge LM

Published in the Lymphat Res Biol Sep;11(3):183-6 2013

Our data demonstrate that LPT may protect against pneumonia by inhibiting bacterial growth in the lung; however, the mechanism of protection is unclear. Once these mechanisms are understood, LPT can be optimally applied to patients with pneumonia, which may substantially reduce morbidity, mortality, and frequency of hospitalization.

Hodge, LM

Published in Int J Osteopath Med. 2012 Mar; 15(1): 13–21. doi: 10.1016/j.ijosm.2011.11.004

This short review highlightsclinical and basic science research studies that support the use of Lymphatic Pump Techniques to enhance the lymphatic and immune systems and treat pneumonia, and discusses the potential mechanisms by which LPT benefits patients with pneumonia.

Mueller, DM

Published in the J Am Osteopath Assoc. 2013 Sep;113(9):703-7. doi:10.7556/jaoa.2013.036.

Use of osteopathic manipulative treatment with vaccination, antiviral therapy, and chemoprophylaxis has potential to save lives and reduce complications. The present article describes the role of osteopathic manipulative treatment in the management of influenza and highlights current issues surrounding the use of antiviral therapy.