Asthma

Q: What is Asthma?

A: Asthma is a Chronic Obstructive Airways Disorder and occurs due to an exaggerated hypersensitivity response to a wide variety of stimuli such as cold air or dust. Muscles around the wall of the airways tighten up causing narrowing. The lining of the airways swell and sticky mucus forms which clogs up the breathing passages causing symptoms of shortness of breath, wheezing, coughing and feelings of chest tightness. It may lead to an acute, immobilizing attack. Asthma attacks differ from person to person, and between attacks many individuals are symptom free. The attacks may occur spontaneously or in response to various triggers, respiratory infections, emotional stress, or weather changes.

What occurs during an asthma attack?

During an attack due to bronchospasm and oedema of the bronchial mucosa the airways narrow and become progressively obstructed causing prolonged expiration. Expiration (breathing out) becomes prolonged because of progressive airway obstruction. The amount of air that can be forcibly expired in 1 second and the peak expiratory flow rate are decreased. During a prolonged attack, air becomes trapped behind the occluded and narrowed airways, causing hyperinflation of the lungs  and an increase in residual volume (RV). More energy is therefore needed to overcome tension already present in the lungs, and the accessory respiratory muscles (Sternocleidomastoid, Scalenes, and Diaphragm muscles) are recruited to maintain ventilation and gas exchange.

Statistics of Asthma

According to the Asthma Association of Ireland asthma prevalence is very high in Ireland. Ireland is number four in the world asthma league after Australia, New Zealand, United Kingdom. It is thought that as many as 470,000 individuals in Ireland suffer from the condition. Over the last two decades there has been a considerable increase in asthma prevalence which although the condition often runs in families is more likely due to a greater change in the environment over this period ( allergic substances, pollution, smoking) or a change in our bodies’ response to the external environment.

Types of Asthma

Typically, asthma has been categorized into extrinsic (atopic) asthma and intrinsic (non-atopic) asthma. Although this distinction is useful from a pathophysiological point of view, it is less useful clinically as many people with asthma manifest overlapping characteristics of the two. 

Extrinsic (Atopic) Asthma: This is typically initiated by a Type 1 hypersensitivity reaction induced by exposure to an outside antigen or allergen. It usually has its onset in childhood or adolescence. Persons with atopic asthma often have allergic disorders such as hay fever, hives and eczema.

Intrinsic (Nonatopic) Asthma: This is often initiated by various nonimmune mechanisms including respiratory tract infections, exercise, ingestion of aspirin, emotional upset, and exposure to cigarette smoke.

Treatments: Many medications are used to manage the symptoms of asthma for both quick relief following an acute attack or long- term medications that are taken daily to achieve and maintain control of persistent asthma symptoms. Medications that are commonly used include corticosteroids, anti-inflammatories, and bronchodilators and are administered  in inhalation and oral forms. It is important that asthma patients liase with their doctor or nurse to ensure that the symptoms are being managed appropriately.

How can Osteopathy treat Asthma symptoms?

Osteopathy is a Complementary Medicine and in conjunction with Allopathic medicine can be helpful in the treatment of Asthma by stretching out and performing Soft Tissue techniques (massage) to the accessory breathing muscles such as Sternocleidomastoid, the intercostal muscles and Diaphragm muscle. These muscles become hypertonic (tight) as they are recruited more for breathing in people who suffer from asthma than those who don’t. An Osteopath will also advise on breathing techniques and perform some rib stretches in order to improve overall respiratory function.

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Tags: Asthma, Chronic Obstructive Airways Disorder, Osteopathy