An Alternative Approach to Median Arcuate Ligament Syndrome

Median arcuate ligament syndrome (MALS) is a rare anatomical anomaly where the median arcuate ligament is too inferior in origin and causes compression of the celiac artery and plexus. Due to the nerve compression, patients with MALS commonly experience other pathologies such as postural orthostatic tachycardia syndrome (POTS), and gastroparesis. These patients often experience dizziness, lightheadedness, syncope, abdominal pain, vomiting, and nausea. This case report follows a 23-year-old female with MALS, POTS, and gastroparesis who was wheelchair bound due to her intense syncopal and pain episodes. After 4 treatments of osteopathic manipulative treatment (OMT) involving visceral techniques to increase bowel movements, as well as treatment of the origin and insertion of the median arcuate ligament, this patient had a substantial decrease in symptoms which allowed for a drastic increase in mobility and quality of life.