Osteopathic Care in a Rare Condition: Gordon Syndrome
Snapshot
- Who: 40-year-old woman living with Gordon syndrome (distal arthrogryposis type 3), a very rare, inherited condition linked to mutations in PIEZO2, a mechanosensitive ion channel.
- Main concerns: Severe, widespread musculoskeletal pain (neck, back, hips), spinal scoliosis, limited neck mobility (“couldn’t hold her head up”), and reflux symptoms (GERD).
- Why osteopathy: Prior physical therapy, chiropractic care, dietary changes, and alternative remedies offered minimal relief; her PCP referred her for osteopathic manipulative treatment (OMT).
Osteopathic Findings
A full structural exam showed multi-region somatic dysfunctions, including OA extension, cervical segmental dysfunctions, thoracic and lumbar patterns with increased lordosis, a unilateral sacral lesion, pelvic rotational/outflare patterns, rib inhalation/exhalation asymmetries, extremity restrictions, and notable celiac and superior mesenteric ganglia restrictions. General exam also noted severe lumbar scoliosis and significantly limited cervical rotation/extension.
Treatment Approach
They started gently, then progressed as tolerated:
- Visit 1 (indirect focus): Counterstrain, traction-articulatory methods, indirect myofascial release, and soft tissue—aimed at down-regulating protective tone and improving glide.
- Visit 2 (added direct methods): Muscle energy, Still’s technique, lymphatic techniques, direct myofascial release, and compression-articulatory methods. Direct myofascial work addressed celiac, superior mesenteric, and inferior mesenteric ganglia to help autonomic balance and visceral symptoms.
- Home care: Trapezius/scalene stretches, later adding a quadratus lumborum stretch.
Why fascia and ganglia matter (for clinicians): Fascia is integral to palpatory diagnosis and OMT—central to biomechanical and respiratory-circulatory models—and commonly addressed in whole-person osteopathic care.
Results
- After Visit 1: Marked reduction in neck stiffness; improved ability to hold her head upright.
- Follow-up: Less GERD, less back/neck pain (after transient post-treatment soreness), better neck range of motion; C2–C5 corrected via cervical articulation and Still’s technique.
- Patient-reported outcomes (selected):
- Neck pain intensity: 10 → 2/10; frequency: several times/day → one–two times last week; work interference: “substantial” → “not at all”.
- Right shoulder pain: 10 → 2/10; frequency and interference both decreased.
- Lower back pain: 10 → 6/10 with reduced interference.
- Knees: Right 5 → 2/10; left 3 → 0/10, with less interference.
- Foot (left): 7 → 2/10; right remained high due to complex history.
Overall, she reported better function and quality of life across multiple regions.
Why this matters
Even in a rare, multisystem condition with congenital structural constraints, a stepwise, full-body OMT plan—starting indirect, adding direct methods as tolerated—can reduce pain, improve motion, and support daily function.
Secondary win: targeting autonomic ganglia and related segments aligned with known OMT strategies for GERD-type symptoms, and the patient reported meaningful relief.
Note for clinicians: The case report also discusses the role of PIEZO2 in mechanosensation and GI function, offering a plausible link between mechanobiology and symptom change in GS.
Limitations
This single-patient report had a short follow-up and no control group. Nonetheless, improvements after two sessions suggest OMT may be a helpful adjunct in complex congenital conditions!
Source
This highlight summarizes an open-access, peer-reviewed case report: Johnson T, Waters HB. “Effects of Osteopathic Manipulative Treatment on Rare Diseases: A Case Report on Gordon Syndrome.” Cureus. Published Oct 18, 2024. DOI: 10.7759/cureus.71778.
About Osteopathic Care
Osteopathic practitioners consider structure–function relationships and use hands-on techniques to improve mobility, circulation, and nervous system balance. Fascia—the body-wide connective tissue network—is core to osteopathic palpation and treatment within the profession’s framework.
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