Sustained release myofascial release as treatment for a patient with complications of rheumatoid arthritis and collagenous colitis: a case report

Abstract

Background: Myofascial release (MFR) is a manual therapeutic technique used to release fascial restrictions, which may cause neuromusculoskeletal and systemic pathology.

Purpose: This case report describes the use of sustained release MFR techniques in a patient with a primary diagnosis of rheumatoid arthritis (RA) and a secondary diagnosis of collagenous colitis. Changes in pain, cervical range of motion, fatigue, and gastrointestinal tract function, as well as the impact of RA on daily activities, were assessed.

Methods: A 54-year-old white woman presented with signs and symptoms attributed to RA and collagenous colitis. Pre and post measurements were taken with each treatment and during the interim between the initial and final treatment series. The patient recorded changes in pain, fatigue, gastrointestinal tract function, and quality of life. Cervical range of motion was assessed. Six sustained release MFR treatment sessions were provided over a 2-week period. Following an 8-week interim, two more treatments were performed.

Results: The patient showed improvements in pain, fatigue, gastrointestinal tract function, cervical range of motion, and quality of life following the initial treatment series of six sessions. The patient maintained positive gains for 5 weeks following the final treatment, after which her symptoms returned to near baseline measurements. Following two more treatments, positive gains were achieved once again.

Conclusions: In a patient with RA and collagenous colitis, the application of sustained release MFR techniques in addition to standard medical treatment may provide short-term and long-term improvements in comorbid symptoms and overall quality of life.

Keywords: Myofascial release; inflammatory bowel disease; manual therapy; rheumatoid arthritis.

Figure 1

Fatigue (P4): comparison of morning, afternoon, evening, and activity fatigue. Overall fatigue was alleviated with myofascial release by the last treatment session of the initial treatment series. The fatigue started to return 5 weeks after the last treatment series and was more severe by 8 weeks. After the final treatment series, the fatigue was eliminated again.

Figure 2

Systemic pain (visual analog scale): comparison of pre and post treatment. Systemic pain was reduced during the initial treatment series and returned during the interim period between the initial and final treatment series. Pain was reduced once again in the final treatment series.

Figure 3

Cervical pain (visual analog scale): comparison of pre and post treatment. The graph depicts a decrease in cervical pain from before each treatment to immediately after each treatment. Cervical pain decreased in the initial treatment series and remained at approximately the same level through the fifth week after the last treatment session of the initial treatment series. Pain was decreased again following one additional myofascial release treatment.