How OMM solved a year-long mystery in 15 minutes

The pain was excruciating, but Cristin Crawley didn’t know why. At the end of the day, she would end up in tears from the pain that had overtaken her for nearly a year, with no solutions in sight.

“The pain was insufferable,” Crawley said. “It was hurting so much to talk, with every word I said my ears were clicking, the pressure was building and I didn’t know why.”

Crawley, a 2022 graduate from The University of North Texas Health Science Center at Fort Worth’s College of Health Professions Masters in Lifestyle Health Sciences program, had a unique situation. Every time she spoke, a persistent clicking noise was made in her ears, not randomly, not occasionally, but every single word throughout an entire day. The built-up pressure this caused in her ears and face was overwhelming, but through two chance encounters with Sajid Surve, DO, FACCPMR, FAAO, osteopathic medicine came to the rescue.

This is the remarkable story of how Crawley’s desperate search for answers was found in osteopathic manipulative medicine (OMM) and the expertise of Dr. Surve.

Allergies

It was December of 2023 when Crawley noticed something was off. She didn’t have health insurance at the time, so she made a quick run to an urgent care clinic hoping for some relief.

“I kept going there and they would tell me it’s a sinus infection or allergies,” Crawley said. “I’ve had allergies in the past, but it was winter so I had a sense that it wasn’t it.”

With no recourse at the time, Crawley did the best she could to alleviate the discomfort with antibiotics prescribed by her physician, which went on for months. Her ears began to snap when she spoke—combined with the popping, it was turning into a cruel version of Rice Krispies snap, crackle and pop.

She did lab work to see if that could shed some light on her problems. The only thing it showed was her liver suffering damage from all the medicine she had taken.

Ear, nose and throat

Crawley found an ear, nose and throat physician to see in April. The initial diagnosis was Patulous Eustachian tube dysfunction, which is a condition where the Eustachian tube remains open, allowing sounds to travel from the sinuses to the ears. This can cause people to hear their own voice, breathing or heartbeat too loudly. In May, Crawley had tubes put into her ears, and at long last there was going to be relief … or so she thought.

Following the surgery, the pain was still there, the discomfort as bad as it had ever been.

“At my next appointment I was in tears because all I felt was pain, just overwhelming pain,” Crawley said. “We were just sitting there and I was asking the doctor if I should just go to the ER or what I should do. Go home and take more Tylenol? I didn’t know what to do.”

In June, after another visit to the doctor, another possible diagnosis was given, temporomandibular joint disorder, or TMJ. Potential ear pain is a common symptom of TMJ because the TMJ is close to the ear and the muscles and nerves in the jaw and ear are connected. But it was just a possibility, nothing was certain. With so much uncertainty, Crawley was given perhaps the most difficult decision of her life to make.

“I was given the option of doing an exploratory surgery in my ear tube where they would put in a stent that could either make me 100 percent better or 100 percent worse,” Crawley said. “This surgery was irreversible, it was either going to work or it wasn’t. If it didn’t work, I was going to have to live with this for the rest of my life.”

She was terrified at the prospect of the surgery and needed time to think things over. Crawley left that visit as she had done so many others, in tears and without answers.

Preview day

Each year, the University of North Texas Health Science Center/Texas College of Osteopathic Medicine (UNTHSC/TCOM) hosts a preview day for prospective medical students and those interested in learning more about osteopathic medicine. On July 27, 2024, UNTHSC/TCOM opened its doors and one of those interested in learning more was Crawley.

After hearing from a few different speakers about UNTHSC/TCOM, it was time for an OMM demonstration for everyone in attendance, led by Dr. Surve, UNTHSC/TCOM’s interim senior associate dean of the office of education programs, but also a physical medicine and rehabilitation expert.

Dr. Surve helped found the UNT Texas Center for Performing Arts Health in 2014, which is now the Division of Performing Artist Medicine at UNTHSC/TCOM and is the preeminent performing arts medicine provider for the DFW Metroplex, treating performers of all disciplines and skill levels.

“I’ve done this for UNTHSC/TCOM each year, and I really enjoy that type of work and promotion of osteopathic medicine because I’m so passionate about it,” Dr. Surve said. “Talking about OMM is not very helpful, it’s much more important to see it happen because it makes more sense. I will usually take a volunteer from the audience and say ‘Hey, come on up,’ almost like a magic show, but I don’t know who that person is. I’ll bring them up and say let’s look at this person together and get the audience involved. It’s good-natured fun.”

Dr. Surve did three different demonstrations that day, and Crawley just so happened to be in the audience for one of them. He asked a question of the audience about osteopathic medicine and Crawley answered it. In fact, she answered it so well, that Dr. Surve asked if she would like to come up and be a volunteer for his OMM demonstration. It didn’t take long for Dr. Surve to find a few anomalies on her.

“When I looked at her, she was asymmetrical and I asked her if she had a fall or trauma happen by the nature of her asymmetries because this doesn’t just happen. It looked like she had taken a hard fall,” Dr. Surve said.

Throughout the 10-minute demonstration, Dr. Surve was able to tell Crawley that one of her legs was actually shorter than the other, straightened her shoulders and aligned her posture.

“He got me up on that table and people at the preview day said the belt that I was wearing had gone from sideways to straight,” Crawley said. “I remember riding home, I felt much more comfortable.”

“Afterwards she thanked me and we chatted briefly,” Dr. Surve said. “I got a sense there was a lot going on here when I initially saw her as a volunteer. When it comes to manipulation, there are a few things you can do very quickly, but to get them completely fixed, there is a lot of work that needs to be done, so in those demonstrations, we are doing quick help, we get them around 80 percent of the way there, which is what I did with her.”

Crawley stayed connected with the school and saw UNTHSC/TCOM’s Student American Academy for Osteopathy was hosting a soft tissue clinic on Aug. 21, 2024, which is an opportunity for students to practice their hands-on OMM skills on volunteers who attend the clinic. After her experience with Dr. Surve, Crawley wasn’t going to miss this one.

“I wasn’t even thinking my ears were related to my neck,” Crawley said.

Up until that point, they weren’t. Crawley hadn’t decided yet about whether to do the surgery or not, but she was leaning in the direction of doing it because she simply had no other options.

The pop

All DOs are trained to promote the body’s natural tendency toward self-healing and health. OMM, which is a hands-on treatment that uses gentle pressure to move joints and tissues, is that extra tool in the DO arsenal of helping the body heal.

Crawley was an athlete, so when Dr. Surve had asked her if she had taken a hard fall, the answer was yes, she had taken many. She had done martial arts for years, but over time and after many falls, her back and neck had succumbed to pain. Crawley went to the clinic with the hope the students could help her with that pain, not her ears.

A handful of UNTHSC/TCOM students were working the clinic, and fate would have it that their faculty supervisor for the day was none other than Dr. Surve. As the students began working on Crawley, they got to her neck and ran into trouble, so they called Dr. Surve over for help.

“They couldn’t unlock her neck; it was really tight. I mean, it was insanely tight,” Dr. Surve said.

Dr. Surve noticed something else—her neck had a lump, but it wasn’t just any lump to Crawley.

“It was the exact spot where all the clicking, all the pain and the source of my agony was coming from,” Crawley said. “He asked if he could pop my neck, and I said yes.”

Her neck popped, and the source of all of her pain, discomfort, trepidation and ruinous moments over the past year had been discovered. It wasn’t her ears, it wasn’t her tubes, it wasn’t her sinuses; it was muscular.

“I remember on the drive home playing with my voice—it’s still clicking but it’s not painful,” Crawley said. “I went to the ENT after that and talked to her about how I went to an OMM clinic. She agreed that maybe this might be a muscular problem.”

They both agreed to put off the risky surgery and instead try physical therapy. Crawley started in September with PT and the results were immediate.

“I got so much better,” Crawley said. “I did eight sessions, and after the third session the agonizing pain went away and by the end of November the clicking in my ears was substantially better, and I felt so much better.”

Crawley had her life back again.

A brief reunion

Dr. Surve had spent a total of 15 minutes working loosely with Crawley on two separate occasions, not even knowing what her real issue was and changed her life. It wasn’t until late December that Crawley reached out to Dr. Surve to tell him about her journey, the agonizing pain she was going through and how his healing hands provided her with the solution for the relief she searched so hard for, but couldn’t find anywhere except osteopathic medicine.

“I didn’t tell anyone about my ear problem—not the students, not Dr. Surve,” said Crawley.

“I was blown away by the story,” Dr. Surve said. “That muscle helped her with the entire other issue she didn’t even mention to us. We were just doing our job and lo and behold we were able to unlock this mystery she was working on this entire time.”

She is able to communicate clearly now, with little to no pain in her ears, and she avoided the surgery she was dreading.

“I was probably going to go forward with the surgery,” Crawley said. “That’s what is so incredible with life; you just never know where it’s going to take you and to say I avoided that by coming here and to that clinic, never in a million years would I have thought my neck correlated to my ears at all, and to feel it outside my body, it’s simply amazing. Dr. Surve has been doing demonstrations and OMM for decades now, he’s simply one of the best, but where could this encounter possibly rank on his list of success stories?”

“In terms of wow factor, it’s right up there,” Dr. Surve said. “The circumstances and how these two random encounters were pretty sufficient, that’s just in my top five percent of amazement. In this case, in both of these encounters, I wasn’t in a doctor role, I was demonstrating in a teaching and educator role, and still having this outcome really puts it over the top as a great surprise.”

Crawley was recently able to thank Dr. Surve in person for his help and to know how impactful two brief encounters changed a life. Like so many other trips this last year, Crawley left another doctor’s office a little misty-eyed, but for the first time with a smile.

“Osteopathic medicine gave me my life back, it’s incredible,” Crawley said.

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