While gastrointestinal problems are common among patients, few physical therapists have undergone the specialty training necessary to manage these issues despite their significant impact on orthopedic conditions like back pain.
Gastroesophageal Reflux Disorder (GERD)
Premature stomach fullness
Difficulty emptying the stomach
of non-viral/bacterial origins
Irritable Bowel Syndrome
Post surgical scar tissue and adhesions
Chronic pain in the abdomen, pelvis, or back
GERD: Some patients diagnosed with GERD who do not get relief with traditional medication treatment from their physician may have more than an acid problem in isolation. Constricted musculature can also generate feelings of heartburn or reflux.
Swallowing: Some difficulty swallowing is due to elevated muscle tone in the esophagus and it's sphincters. Scar tissue from surgical procedures or radiation therapy to the neck can also make swallowing difficult.
*Weakness and neuromuscular control deficits of the swallowing muscles are sometimes better addressed by a speech therapist. Your therapist may recommend referral to speech therapy if appropriate.
The ability to move food through your intestines at the appropriate rate is essential for nourishment and digestion. If this motility has been restricted by scar tissue from surgeries or chronic inflammatory conditions, it can cause a host of problems ranging from nausea to constipation and diarrhea.
Visceral mobilization can help facilitate the right amount of motility and appropriate levels of fluid balance in the body to reduce your symptoms.
*Pelvic floor physical therapy may be beneficial in conjunction with visceral mobilization for some patients.
What to Expect
A visceral specializing therapist will work to assess the mobility of the different organs and tissues in your throat, thorax and abdomen. This is done by the application of pressure to the various tissues through the therapist's hands.
If the tissue mobility is restricted, your therapist will provide manual therapy treatments to improve the movent of food and liquid through your system starting with the esophagus and ending with the rectum. If appropriate, the therapist may instruct you on how to perform these treatments to yourself at home.
Feelings of fullness in your stomach can limit your ability to eat, and even make you nauseous to the point of vomiting. If the mobility of your stomach and it's attachment to your intestines is restricted, improving the mobility can reduce your symptoms.
If your symptoms are due to chronic conditions such as diabetic gastroparesis, your therapist will work to teach you self mobilization techniques to ease your daily symptoms.
Impact on back pain
The abdominal viscera are notorious for referring their pain to other places. If your back pain has not responded to traditional orthopedic therapy, it may be time to work with your doctor to see if there is more going on. This is especially true if your back pain is impacted by eating, certain foods, or bowel movements.
Your physical therapist may find it necessary to refer you for other testing. Doctors may study the human body in specialties, but it works as a whole. Your physical therapist is a valuable part of your team, but we may need to be in communication with your other doctors too.