Breath of Relief: Osteopathic Manipulative Treatment of Chronic Postoperative Pain in a Bilateral Lung Transplant Patient.

Critical stage lung disease often requires treatment with a lung transplant. This procedure can change the quality of a patient's life, but it does not come without its potential complications. Chronic postoperative pain is one such complication, which is underaddressed and not properly managed. While current management revolves around the use of medications, it is often insufficient. Osteopathic manipulative treatment (OMT) is an additional means of treatment that has been well studied in its ability to address somatic dysfunctions, decrease stiffness, improve respiratory function, and minimize pain. Our 56-year-old patient, who was status-post bilateral lung transplant in 2022, presented to our clinic due to chronic back pain, stiffness, inspiratory pain, and generalized weakness. While her vitals were within normal limits and her general physical exam was benign, her osteopathic structural exam was significant. Alongside thoracic and lumbar restrictions, she presented with hypertonicity of her right latissimus dorsi, serratus anterior, subscapularis, and psoas muscles. She also had articular restrictions of her right ribs. After undergoing OMT for the next five months, the patient continued to report extended bouts of pain relief as well as a decrease in pain with deep inhalation. Her initially reported six out of 10 pain became a consistent two out of 10. She also reported an increase in back strength, a reduction in stiffness, and an overall increase in comfort, allowing her to sleep easily at night. While bringing more attention to chronic postoperative pain, this case demonstrates the efficacy of OMT in becoming an additional part of its management.