Chapman reflex points
Last updated: January 3, 2024
Summary![toggle arrow icon](https://manus-media.amboss.com/icons/chevron_up.svg)
Chapman reflex points refer to nerve gangliform contractions located deep in the skin and subcutaneous tissue, most often within the deep fascia or periosteum of the bone. These neurolymphatic points are found in specific areas of the body that correspond to visceral dysfunctions. Pain at any of these points represents potential internal dysfunction or pathology of a specific organ. They can be felt as small, discrete, and smooth palpable nodules, approximately 2–3 mm in diameter. Although Chapman points are typically diagnostic, they may also be manipulated for therapeutic purposes.
Sources differ on the precise Chapman points.
Description![toggle arrow icon](https://manus-media.amboss.com/icons/chevron_up.svg)
Characteristics![toggle arrow icon](https://manus-media.amboss.com/icons/chevron_up.svg)
- Round, smooth, discrete, and tender palpable nodules (∼ 2–3 mm in diameter)
- When compressed, they cause sharp, non-radiating pain
- Associated with visceral dysfunctions (i.e., viscerosomatic reflexes)
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Location
Anatomy![toggle arrow icon](https://manus-media.amboss.com/icons/chevron_up.svg)
Cardiorespiratory
Gastrointestinal
Gastrointestinal Chapman points |
Chapman point | Anterior | Posterior |
Esophagus | 2nd ICS, at the sternocostal junction | T2, midway between spinous and transverse process |
Stomach (acidity) | 5th ICS on the left | Left intertransverse space between T5 and T6, midway between spinous and transverse process |
Stomach (peristalsis) | 6th ICS on the left | Left intertransverse space between T6 and T7, midway between spinous and transverse process |
Pylorus | N/A | Costotransverse junction on the right 10th rib |
Liver | 5th – 7th ICS on the right | Right intertransverse spaces between T5 and T7, midway between spinous and transverse process |
Gallbladder |
Pancreas | 7th – 8th ICS on the right | Right intertransverse space between T7 and T8, midway between spinous and transverse process |
Spleen | 7th ICS on the left | Left intertransverse space between T7 and T8, midway between spinous and transverse process |
Duodenum | 8th ICS near the costochondral junction | Intertransverse space between T8 and T9, midway between spinous and transverse process |
Jejunum | 9th ICS near the costochondral junction | Intertransverse space between T9 and T10, midway between spinous and transverse process |
Ileum | 10th ICS near the costochondral junction | Intertransverse space between T10 and T11, midway between spinous and transverse process |
Appendix | Tip of the 12th rib on the right | Right intertransverse space between T11 and T12, midway between the tips of the transverse processes |
Cecum | Upper 1/5 of the right proximal femur | Triangular area between the transverse process of L2, iliac crest, and transverse process of L4 |
Ascending colon | Middle 3/5 of the right lateral thigh |
Hepatic flexure | Lower 1/5 of the right distal femur |
Sigmoid colon | Upper 1/5 of the left proximal femur |
Descending colon | Middle 3/5 of the left lateral thigh |
Splenic flexure | Lower 1/5 of the left proximal femur |
Rectum | Proximal inner thighs on the lesser trochanter | Sacrum, level of S2, near the lower end of the sacroiliac articulation |
Genitourinary
Endocrine
![Anterior Chapman points (osteopathy)](data:image/jpeg;base64,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)
![Posterior Chapman points (osteopathy)](data:image/jpeg;base64,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)
Approach![toggle arrow icon](https://manus-media.amboss.com/icons/chevron_up.svg)
General considerations
Chapman reflex points are typically utilized selectively for diagnostic purposes. However, they may also be manipulated for therapeutic purposes.
- Somatic manifestations help diagnose visceral dysfunctions.
- Both the anterior and posterior points need to be present to be considered a Chapman reflex.
- Reflex points can be slightly painful to extremely tender without radiation → signifies potential visceral dysfunctions of the corresponding organ
Treatment
- Goal: decrease sympathetic tone, improve myofascial motion and lymphatic drainage
- Technique: apply deep, firm, or gentle pressure, alternating clockwise and counterclockwise motions for 1–5 minutes, until the point softens or disappears and the pain is reduced.
- Associated somatic dysfunctions may also be treated separately.
References![toggle arrow icon](https://manus-media.amboss.com/icons/chevron_up.svg)
- Seffinger M. Foundations of Osteopathic Medicine. LWW ; 2018
- Nicholas A. Atlas of Osteopathic Techniques. LWW ; 2015