Complementary Medicine Practices for Muscular Injuries of the Posterior Leg

Abstract

Complementary treatments for musculoskeletal injuries commonly include manual therapies such as traditional Chinese medicine, osteopathic manipulation, chiropractic medicine, naprapathic medicine, massage therapy, injection therapies, and transdermal modalities. Many of these treatments have been used for years, in some cases thousands of years, as an alternative to standard treatments. However, the evidence for these modalities is often only anecdotal at best due to lack of high-quality studies. Despite years of use with success in patients, the surge in evidence-based medicine has maligned these treatments due to the lack of evidence. However, it should be noted that even some standard therapies lack high-quality evidence, but continue to be used due to tradition. Nonsteroidal anti-inflammatory drug (NSAID) use for chronic tendonitis is one example. But, just because the studies are lacking it does not mean these therapies are not effective. One underlying commonality with all of these complementary treatments is the effect on the fascia through physical intervention. For years, researchers have tried to develop blinded, placebo-controlled, randomized trials. However, trying to develop a placebo for physical interventions like touch or the insertion of an acupuncture needle is difficult. Sham treatments used as placebo still have the physical interaction between patient and practitioner, and may have some effect. Even more difficult is trying to blind the researchers and study subjects to the physical interventions. However, research on the fascia, as well as the biology of manual therapies, is giving insight into how it affects muscle function, vascular function, and nerve function. This chapter gives a brief history of complementary medical philosophies and looks at their role in the treatment of posterior lower extremity injury.

Bo M. Rowan is deceased.