Surgical treatment options for patients with colonic inertia are costly and do not always relieve the pain associated with the condition. The author describes a case of a 41-year-old woman with colonic inertia who received osteopathic manipulative treatment targeted at the neuromusculoskeletal and gastrointestinal systems. The patient reported temporary improvement in pain and bowel function without pharmacotherapy or surgical intervention. Osteopathic manipulative treatment should be considered in patients with visceral as well as neuromusculoskeletal symptoms.