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Vagus Nerve Stimulation

2/24/2022

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The vagus nerve is your body’s longest nerve, and the biggest parasympathetic nerve in your body.
The parasympathetic nervous system is responsible for rest and digest functions in your body.
The vagus nerve is the tenth cranial nerve, and runs from your skull down both sides of the neck and chest to your abdomen and intestines.
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The word vagus stems from a latin word for wanderer, which describes the nature of the vagus nerve well, since it wanders to most organs on its way.
When stressed we tend to go into fight or flight mode, which is the sympathetic nervous system’s job. Most people nowadays spend way too much time in that state, which causes all kinds of problems.


​You can read more about that in the article about stress.

Stimulating the vagus nerve is one way of helping your body come back from the constant fight or flight and to calm down so that it can relax, heal and digest your food.
Most of the information in the vagus nerve runs from bottom up, ie from the organs, like the intestines, to your brain.
That is why being in your body and doing physical activities will help in relaxation and feelings of safety.

Here are some tips on how to stimulate the vagus nerve and help you to relax and get to a state of healing:
● Because of the way the nerve runs at the back of your throat, humming, chanting, gargling and singing all create a vibration that stimulates the nerve

● Laughing (and socialising), for the same reason as above, but also, you can’t be really socially engaged without being in parasympathetic state
● Deep breathing stimulates the vagus nerve. If you want it to be extra beneficial, breath out longer than you inhale.
● Cold immersion has been shown to increase vagus nerve tonus, so ending your morning shower with 30s to a few minutes of cold water immersion can be helpful. If that’s too much, you can just begin by immersing your face in cold water for short periods.
● Meditation and mindfulness
● Massage, especially foot massage
● Devices like Sensate that vibrate on your sternum.
● Osteopathy in the cranial field is a very efficient way of stimulating your parasympathetic nervous system and getting the body into a space where it can heal itself.

​You don’t have to do them all, just choose one or a couple that work for you and see how you go. Some might work better for you, and some for others, so you might have to go through some trial and error.

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As osteopaths we can work with you to bring your body back to nervous system balance, and we’d love to help you on your journey back to health. Please check out our website link below for more information or give us a call on 04 4991439.
​ www.cityosteopaths.co.nz

​References:
Forsythe P, Bienenstock J, Kunze WA. Vagal pathways for microbiome-brain-gut axis communication. Adv Exp Med Biol. 2014;817:115-133. doi:10.1007/978-1-4939-0897-4_5

Kalyani BG, Venkatasubramanian G, Arasappa R, et al. Neurohemodynamic correlates of 'OM' chanting: A pilot functional magnetic resonance imaging study. Int J Yoga. 2011;4(1):3-6. doi:10.4103/0973-6131.78171

Kok BE, Coffey KA, Cohn MA, et al. How positive emotions build physical health: perceived positive social connections account for the upward spiral between positive emotions and vagal tone [published correction appears in Psychol Sci. 2016 Jun;27(6):931]. Psychol Sci. 2013;24(7):1123-1132. doi:10.1177/0956797612470827
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Venla Kärki Reg Osteopath, MONZ
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Stress

2/23/2022

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                                                    Stress - the omnipresent bane of our existence.
​ Most people would say they have it, though not everybody realises how much it affects their life.
This article will cover some of the physical aspects of stress, how it affects our body and mind and what you can do about it.

Stress in itself isn’t negative but helps us to act in a tough situation (fight or flight) and to evolve (eg. workouts). The body will have a physical reaction to stress regardless of the type of stressor (physical, mental, emotional). 
A stressor is an event that takes the body out of homeostasis (balance). The stress response strives to bring the body back to a state of homeostasis (bodily functions are in balance). Hormones are secreted in stress; mostly adrenaline (epinephrine) and cortisol. Adrenaline is secreted rapidly and the effect lasts only a short while.
Cortisol, on the other hand, is secreted more slowly but the effect lasts longer. These hormones help us to fight or run away from danger. They release energy from the body’s reserves. They help regulate the blood flow to the vital organs and the muscles. Energy is spared from ‘unnecessary functions’ like digestion, reproduction, growth and healing. Also pain perception is altered; often people don’t feel the pain before the situation calms down.
​When lasting for a short while, all this is very good for our survival. It isn’t until it becomes chronic that it becomes a problem
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We as humans have a unique ability to cause ourselves stress with our thoughts. The body can’t distinguish psychological stressors from purely physical ones (“you have to run to survive”). And so a reaction that’s meant to last for a few minutes can last several days and weeks, which is not what Nature intended.
This causes the body to shift its attention away from important functions such as digestion, growth, recovery, reproduction etc. Symptoms such as tiredness, overwhelm, hair thinning, loss of libido, weight gain and poor sleep quality, are all signs of chronic stress. 

Also when we get stressed we tend to tense up, especially in the neck and shoulders. We start breathing more shallowly and lose our sense of safety, being on high alert (hyper-arousal).
This is nature's way of protecting the important structures and preparing us for a fight or flight, if possible, or freeze, if the fight or flight is not a viable option in the situation.
Because we often don’t get to run away from our stress inducing thoughts, the stress becomes chronic and so do the changes in our bodies, leading to neck and shoulder pain, low back pain, tension headaches and even migraines. In chronic stress the body doesn’t get a chance to relax or heal.
Also digestive problems such as being too loose or constipated, increase because the body is in constant sympathetic overdrive (fight or flight) which means it doesn’t use its energy for digestion (parasympathetic => rest and digest).

                                                   
​                                                      So what can you then do to help yourself?

Ideally, the best course of action is to reduce the stressors in your life, whether they be physical or mental. The second best is to have daily practises that alleviate the effects of stress.
Your attitude matters: is it anxiety or excitement? You can change how you relate to stress, and the differences in physical reactions come from how you interpret them: If you feel stress more as a threat than a positive challenge, it will increase your cortisol secretion.
Short bursts (up to a minute) of intense exercise help to reduce the levels of stress hormones and use up the energy released by the stress hormones in the body by mimicking running away from the danger. Walks in nature also help to ground us and stay more present, which reduces stress. Also, meditation and mindfulness exercises help you to stay in the present and reduce stress when practised regularly. You can start with just 3-5 minutes a day!
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Deep breathing exercises and vagus nerve stimulation help to activate your parasympathetic nervous system, the rest and digest part of your body’s autonomic nervous system.

                                                    What can an osteopath do for you, to help with stress?
As osteopaths we treat the person as a whole, taking into consideration the physical, mental and emotional aspects. In addition to working on the tight muscles, we might suggest minor lifestyle changes and hacks for de-stressing, give recommendations for supplements and provide exercises to help you recover.
Cranial osteopathy is very beneficial in relaxing the body and restoring its energy, helping the body to calm to a state where it can once more heal itself.

In addition to treating the tight neck and back muscles which may be causing you pain and tension headaches, your osteopath can also work on your thoracic diaphragm to help you with deep breathing. This diaphragm tends to get tense if not used to its full capacity for deep breathing, and thus deep breathing can be challenging initially, although when done daily, or even several times a day, can produce very rewarding results.

If you’re ready to take control of your stress, get out of pain and be helped back to health, come and see our osteopaths at City Osteopaths for your individualised treatment plan to recover your health and feel really good again.
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Venla Kärki Reg Osteopath, MONZ
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Mood disorders, your diaphragm muscle of breathing and Osteopathic Manual Treatment

1/11/2022

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According to New Zealand based research by Kovanur and Roy (2015), most practising osteopaths in Aotearoa come across patients with a history of mood disorders.

As the New Zealand mental health 2020/2021 survey has shown, psychological distress in adults, and also in children, has increased from 7.5% the previous year possibly due to the pandemic and lockdowns.

According to the same research, 100% of manual therapists perceived the need to manage and support clients with mood disorders during the osteopathic treatment. Being a current topic, I decided to show the evidence from our osteopathic point of view in how to manage patients affected by mood disorders. “Mood disorders are defined as serious mental illnesses that include depression, negative thoughts, anxiety, mood swings and bipolar behaviour”.

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​Osteopathic point of view and manual treatment
The balance between health and disease will always depend on the dynamic interaction between the intrinsic components of physical, mental and emotional states. Thus, a dysfunction of one of these three components can have repercussions on the others.
The core principle of osteopathy is that “structure and function are interrelated at all levels”.

In this context, it has been studied that emotional stress can alter the functionality of the cardiovascular, respiratory and musculoskeletal structural systems, increasing blood pressure, pulse, respiratory rate and sustaining the onset of musculoskeletal disorders.

Diaphragm muscle
Mood disorders commonly affect the functionality of the respiratory system and, consequently, the structure of the respiratory diaphragm muscle. During a stressful time, it has been shown that people tend to breathe quickly and shallowly, constantly increasing the tension in the diaphragm muscle
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Osteopathic manual treatment
At City Osteopaths, we offer fascial visceral treatment to assist the diaphragm muscle and the very gentle cranial osteopathic approach via the cranial rhythmic impulse. We also further support your recovery with the addition of specific guidance in breathing exercises, to help normalise the psychosomatic and somatic states.

Musculoskeletal system
​As mentioned above, diaphragm muscle dysfunction can happen as a consequence of mood disorders; but what is the connection with the musculoskeletal system and pain? To clarify this concept it is important to mention some anatomical information.
The diaphragm muscle is the most important respiratory muscle and it separates the thoracic cavity from the abdominal cavity. There are three attachments of the diaphragm: the xiphoid process of the sternum, costal cartilages of ribs 7-12, lumbar vertebrae ligaments, arcuate ligaments, right crus that arises from L1-L3 vertebrae and left crus that arises from L1-L2 vertebrae. The muscle fibres of the diaphragm combine to form a central tendon. Its innervation is via the phrenic nerve from the cervical roots of C3-C5.  

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If the diaphragm goes into fatigue, it follows that its attachments have a structural mechanical overload causing rib cage, dorsal spine and low back pain. Moreover, it’s also a common cause of neck pain in patients with high levels of stress, due to the neurological connection of the phrenic nerve that receives excessive aberrant signals from the dysfunctional diaphragm muscle back into the neck nerve spinal roots.

Osteopathic manual treatment
At City Osteopaths, we put into practice anatomical principles to treat the body structure and vertebral column in order to improve the function of the diaphragm muscle and, consequently, helping patients affected by mood disorders to increase their quality of life. Our goal is the patient’s wellbeing and we assist this with manual therapy.
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Bibliography:
● https://www.health.govt.nz/publication/annual-update-key-results-2020-21-new-zealandhealth-survey
● Kovanur Sampath, K. and Roy, D. E. (2015) ‘Management of mood disorders by osteopaths in New Zealand: A survey of current clinical practice’, International Journal of Osteopathic Medicine, 18(3), pp. 161-170.
● Paulus, S. (2013) ‘The core principles of osteopathic philosophy, International Journal of Osteopathic Medicine, 16(1), pp.11-16.
​ ● Sagrillo, L. M. and Frigo, L. F. (2016) ‘The respiratory diaphragm in osteopathic vision: a literature review’, MTP & Rehab Journal, 14: 414, pp. 1-6
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PTSD and Osteopathic Treatment a research based article

1/12/2021

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PTSD can be a lifelong recurring disorder which affects the quality of life for the individual and those around them. Traumatic experiences can result in an autonomic response consistently maintained in the defensive state, which over time becomes a stressor. There can be long term health repercussions. 

Imbalances between the sympathetic and parasympathetic aspects of the autonomic  nervous system can lead to alterations in the normal homeostatic function of the body (1). Organ dysfunction from a hyper-aroused, sympathetic dominant state may include the speeding up of the digestive tract, altered respiratory and cardiovascular function and endocrine secretions throughout the whole body. This can lead to the symptoms of anxiety, rapid pulse, shallow breathing, panic attacks (2,7,8). Osteopaths have a wide range of manual techniques to improve physiological functioning of the body and regain homeostasis (3).

When the sympathetic nervous system is hyper-aroused, experienced Osteopaths are able to gauge this using very sensitive whole hand palpation. Osteopathic treatment approaches such as Muscle Energy Technique, Balanced Ligamentous Tension, Osteopathy in the Cranial field and Biodynamic Osteopathy are able to assist the body in restoring balance to the autonomic nervous system (4,5,6) . 

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Research has shown that patients with PTSD using mind-body therapies reported positive effects on their PTSD symptoms, including therapeutic effects on stress responses; reductions in anxiety, depression, and anger; an increase in pain tolerance; improved self-esteem; and an enhanced ability to relax and to cope with stressful situations (9). 
 
Mind-body therapies such as osteopathic treatment of the muscles, ligaments and peripheral nervous system work by stimulation of somatic, visceral, and/or chemosensory receptors, influencing central neural processing and mental processes via ascending pathways from the periphery to the cerebral cortex, resulting in increased heart rate variability and reduced expression of cytokines (10). This effectively reduces the symptoms of PTSD which cause distress to the individual.
 

References:

(1) Effectiveness of an osteopathic treatment on the autonomic nervous system: a systematic review of the literature
(2) Berthoud HR, Neuhuber WL. Functional and chemical anatomy of the afferent vagal system. Auton Neurosci. 2000;85(1-3):1-17. [CrossRef] [PubMed]
 
(3) Campbell SM. Winkelmann R. Walkowski S. Osteopathic Manipulative Treatment
Novel Application to Dermatological Disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3486778/
 
(4) Collard K. Preliminary prediction models for autonomic nervous system response to a cranial osteopathic technique https://unitec.researchbank.ac.nz/bitstream/handle/10652/1387/Kim%20Collard%20MOst.pdf;jsessionid=9EED965260A4FFEAFEF818BF863166E6?sequence=1
 
(5) Dowling DJ, Scariati PD. General Physiologic Considerations. In: DiGiovanna EL, Schiowitz S, Dowling DJ, eds. An Osteopathic Approach to Diagnosis and Treatment. 3rd ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2005:38-52.
 
(6) Van der Kolk BA. Clinical implications of neuroscience research in PTSD. Ann N Y Acad Sci. 2006;1071(1):277-293. doi: 10.1196/annals.1364.022 [CrossRef]
 
(7) Foreman RD, Qin C, Jou CJ. Spinothalamic system and viscerosomatic motor reflexes: functional organization of cardiac and somatic input. In: King HH, Jänig W, Patterson MM, eds. The Science and Clinical Application of Manual Therapy. Edinburgh, Scotland: Churchill Livingstone Elsevier; 2011:11-127.
 
(8) Klarer M, Arnold M, Günther L, Winter C, Langhans W, Meyer U. Gut vagal afferents differentially modulate innate anxiety and learned fear. J Neurosci. 2014;34(21):7067-7076. doi: 10.1523/JNEUROSCI.0252-14.2014 [CrossRef] [PubMed]
 
(9) Kim SH, Schneider SM, Kravitz L, Mermier C, Burge MR. Mind-body practices for posttraumatic stress disorder. J Investig Med. 2013;61(5):827-834. doi: 10.2310/JIM.0b013e3182906862 [CrossRef] [PubMed]
 
(10) Taylor AG, Goehler LE, Galper DI, Innes KE, Bourguignon C. Top-down and bottom-up mechanisms in mind-body medicine: development of an integrative framework for psychophysiological research. Explore (NY. ). 2010;6(1):29-41. doi: 10.1016/j.explore.2009.10.004 [CrossRef] [PubMed]
 
​
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​Melanie Young
B.A., BSc.(Clin Sc.) B.Osteo Sc. MONZ
Reg Osteopath
​Director City Osteopaths
Wellington
​New Zealand

​Phone 04 4991439

http://www.cityosteopaths.co.nz

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