Overview
Somatic dysfunction may be defined as an impairment, or altered function, of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic, and neural elements (Foundations for Osteopathic Medicine, 2nd ed, pg. 1249).
Somatic Dysfunction may be diagnosed by the presence of some, but not necessarily all, of the following:
- Tissue Texture Abnormalities -- Surrounding tissues may feel hypertonic, rigid, fibrosed, atrophied, or edematous.
- Asymmetry of Bony Landmarks and/or Function -- Bones, muscles, or joints may lack symmetry when compared to related structures.
- Restriction of Motion -- A joint with a somatic dysfunction will have abnormal characteristics of motion. During the diagnostic process you should be constantly asking yourself the following four questions:
- Is the total range of motion symmetric?
- Is the total range of motion reduced from normal?
- What is the quality of the motion?
- What is the characteristic feel at the end point of motion?
- Tenderness to Touch -- Pain may result from palpation of tissues associated with somatic dysfunction.
Somatic dysfunction can be further classified as shown in the following table.
Diagnostic Element |
Characteristics of Acute Condition |
Characteristics of Chronic Condition |
| History |
Recent injury |
Long-standing condition |
| Tissue Texture Changes |
Hypertonic muscles, muscle spasms, boggy edema, moist skin |
Decreased muscle tone, dry skin, decreased or no edema, fibrotic and/or ropy tissues |
| Asymmetry |
Present |
Present with compensation in other parts of the body |
| Restriction |
Present, painful with movement, sluggish quality |
Present, decreased or no pain, normal quality within the range that remains |
| Tenderness |
Severe, sharp, minimal evidence of somato-visceral effects |
Dull, achy, burning, evidence of somato-visceral effects |
