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Head injury, loss of smell and osteopathy

Anosmia or loss of smell is common with concussions, closed head injury or traumatic brain injury. Osteopathic treatment can relieve it.

Not too long ago I began treating a young man who had undergone a severe head injury which resulted in a total loss of smell, headaches, problems sleeping, and pain in other areas of his body. He had been crossing the street when a bicyclist hit him, knocked him off his feet, and left him on the ground. He sustained loss of consciousness and a major laceration to the back of his head. He was taken to a local university hospital, the laceration sewn up, and kept for two days for observation.  He was then released.

He came home and shortly thereafter came to me for evaluation and treatment. From 1988 to 1991 I was a resident in training at the National Rehabilitation Hospital, Washington, DC. My residency was in PMR ( Physical medicine and rehabilitation). As part of my training I spent three months working on the brain injury unit which was staffed by neurologists. I was trained in the most current methods of treating head and brain trauma.

However, none of them seemed to really make a marked difference in the outcomes for these patients. Many of these patients were left with lifelong problems related to their traumatic brain injuries.

I used my osteopathic skills in diagnosing and treating my patient and after four visits he has made progress which I would like to report on.

He no longer has any headaches. He sleeps well. He has no cognitive issues reported. He is soon due to return to work full time.

But what is most remarkable is that, according to his conservative estimate, at least 50% of his sense of smell has returned. And it is continuing to return with each visit.

He went to see three neurosurgeons to follow him after his accident.

All three told him that he would never again be able to smell following such a trauma. They based this on his imaging studies and the clinical literature. The cranial nerve responsible for smell, the olfactory nerve, sends tiny roots through a bone at the front of the skull called the ethmoid. This bone was traumatized during the accident. So according to the neurosurgeons it would never again permit the olfactory nerve to normally function and the patient would no longer be able to smell.

During the initial osteopathic exam I found that the ethmoid bone had been traumatized and the membranous tissues around it severely strained. This resulted, in part, in the loss of smell.

I treated his diaphragm which had gone into spasm with the accident. This began to restore normalized respiration. I treated the major sprains and strains to the fascia of the chest and left side of the cranium where the most severe injuries were to be palpated. And I worked especially to get the ethmoid functioning as best as possible.

Many more dysfunctions were palpated and successfully treated with function normalized. This all resulted in improved function and less symptoms.

The neurosurgeons told him that he was just imagining the return of smell. It was technically impossible for him to be able to smell. But he insisted that not only was he able to smell but each visit he could smell more and more. At first ground coffee. Then chocolate. Then finally unpleasant smells like urine and feces from his young child. The progress continues on all fronts.

And the neurosurgeons continue to deny that he is experiencing what he says he does.

It is impossible they say.

But my patient knows differently.