The possibilities of using local thermometry to objectify the effect of osteopathic correction in patients with dorsopathy at the cervicothoracic level

Introduction. Neurological manifestations of osteochondrosis of the spine are among the most common
processes contributing to the onset of chronic pain syndrome. For a number of reasons, there are still diffi culties in treatment of this group of diseases. That is why in recent years the interest of the medical community to non-medicamentous methods of treatment, such as osteopathy, has reasonably increased. At the same time, the problem of objectifying somatic dysfunctions, as well as the results of osteopathic treatment, is quite acute.

Goal of research — to assess the dynamics of the local temperature in the zones of regional somatic dysfunctions against the background of osteopathic treatment in patients with dorsopathy at the cervicothoracic level.

Materials and methods. Longitudinal study was carried out in the specialized osteopathic clinic «Mokhov Institute of Osteopathy» from 01.2018 to 06.2018. The study involved 18 patients aged 25 to 45 years with dorsopathy at the cervicothoracic level. All patients underwent a clinical osteopathic examination. A visual analogue pain scale was used to assess the severity of the pain syndrome. Local thermometry was performed in the areas of identifi ed regional somatic dysfunctions. Each patient underwent individual osteopathic treatment based on the results of osteopathic diagnosis. At the time of the study patients did not receive any other treatment.

Results. Against the background of osteopathic treatment, the mean number of revealed somatic dysfunctions decreased from 9±0,5 to 4±0,2 (p<0,05) per patient. Prior to treatment, there was a decrease in the local temperature and the presence of signifi cant thermic asymmetry in the cervical, thoracic, lumbar and pelvic regions. In the region of the head, on the contrary, there was an increase in the local temperature. In other regions the level of thermal asymmetry was insignifi cant. After osteopathic correction, a statistically signifi cant (p<0,05) dynamics (a decrease in the expression of thermic asymmetry) was obtained in the following regions: the cervical region (the structural component), the thoracic region (the structural component), the lumbar region (the structural component), the region of the head. Also, the treatment contributed to the signifi cant reduction in the severity of pain syndrome in patients.

Conclusion. At the present stage, non-pharmacological methods of treatment can signifi cantly expand the possibilities of therapy and rehabilitation of different kinds of patients including neurological ones. The local thermometry method can potentially be used to objectify the effect of osteopathic treatment.

1. Radhofer-Welte S., Rabasseda X. Lornoxicam, a new potent NSAID with an improved tolerability profi le. Drugs Today 2000; Jan; 36 (1): 55–76. https://doi:10.1358/dot.2000.36.1.566627.

2. Федин А. И. Дорсопатии (классификация и диагностика). Нервные болезни 2002; 2; 2–8. Fedin A. I. Dorsopathy (classifi cation and diagnosis). Nervous Diseases 2002; 2; 2–8.

3. Парфенов В. А. Причины, диагностика и лечение боли в нижней части спины. Неврология, нейропсихиатрия, психосоматика. 2009; 1 (1): 19–22. Low back pain: causes, diagnosis, and treatment. Neurology, Neuropsychiatry, Psychosomatics 2009; 1 (1): 19–22. https://doi.org/10.14412/2074-2711-2009-17.

4. Агасаров Л. Г. Технологии восстановительного лечения при дорсопатиях: Учебное пособие. М.: Вузовский учебник; 2010; 96 с. Agasarov L. G. Tehnologii vosstanovitel′nogo lechenija pri dorsopatijah: Uchebnoe posobie [Technologies of restorative treatment with dorsopathy: Textbook.] M.: Vuzovskij uchebnik; 2010; 96 p.

5. Дубинина Т. В., Елисеев М. С. Боль в нижней части спины: распространенность, причины, диагностика, лечение. Неврология, нейропсихиатрия, психосоматика. 2011; № 1; 22–26. Dubinina T. V., Eliseyev M. S. Low back pain: prevalence, causes, diagnosis, treatment. Neurology, Neuropsychiatry, Psychosomatics 2011; 3 (1): 22–26. https://doi.org/10.14412/2074-2711-2011-129.

6. Подчуфарова Е. В. Актуальные вопросы острой и хронической боли в пояснично-крестцовой области. Неврология, нейропсихиатрия, психосоматика. 2012; № 1; 27–35. Podchufarova E. V. Acute and chronic lumbosacral pain: Topical problems. Neurology, Neuropsychiatry, Psychosomatics 2012; 4 (1): 27–35. https://doi.org/10.14412/2074-2711-2012-358.

7. Кузьмина И. В. Оптимизация рефлекторных методов воздействия при дорсопатиях: Диссертация. М.: РНЦ МРиК, 2015. Kuzmina I. V. Optimization of refl ex methods of infl uence at dorsopathies: Dissertation. M.: RSC for MRB, 2015.

8. Шостак Н. А., Правдюк Н. Г. Боль в шее (цервикалгия) — подходы к диагностике и терапии. Справочник поликлинического врача 2008; 2: 73–77. Shostak N. A., Pravdyuk N. G. Pain in the neck (cervicalgia) — approaches to diagnosis and therapy. Spravochnik poliklinicheskogo vracha 2008; 2: 73–77.

9. Попелянский Я. Ю. Ортопедическая неврология (Вертеброневрология): Руководство для врачей. М.: МЕДпрессинформ; 2011; 672 с. Popeljanskij Ja. Ju. Ortopedicheskaja nevrologija (Vertebronevrologija): Rukovodstvo dlja vrachej [Orthopedic neurology (Vertebroneurology): A guide for doctors]. M.: MEDpress-inform; 2011; 672 p.

10. Воробьева О. В. Скелетная мускулатура как причина локальных болевых синдромов. Consilium medicum. Неврология. Ревматология 2012; 2 (14): 39–42. Vorobyeva O. V. Skeletal musculature as the cause of local pain syndromes. Consilium medicum. Neurology. Rheumatology 2012; 2 (14): 39–42.

11. Мохов Д. Е., Марьянович А. Т. Остеопатия как доказательная медицина. Российский остеопатический журнал 2013; 1–2 (20–21): 138–154. Mokhov D. E., Maryanovich A. T. Osteopathy as Evidence-Based Medicine. Russian osteopathic journal 2013; 1–2 (20–21): 138–154.

12. Потехина Ю. П., Голованова М. В. Причины изменения локальной температуры тела. Медицинский альманах 2010; 2 (11): 297–298. Potehina Yu. P., Golovanova M. V. The reasons of the change of local body temperature. Medical Almanac 2010; 2 (11): 297–298.

13. Вепхвадзе Р. Я. Медицинская термография. Тбилиси: Сабчота Сакартвело; 1975; 109 с. Vephvadze R. Ja. Medicinskaja termografi ja [Medical thermography]. Tbilisi: Sabchota Sakartvelo; 1975; 109 p.

14. Колесов С. Н., Воловик М. Г., Прилучный М. А. Медицинское теплорадиовидение: современный методологический подход. Нижний Новгород: ФГУ «ННИИТО Росмедтехнологий». 2008, 184 с. Kolesov S. N., Volovik M. G., Priluch nyj M. A. Medicinskoe teploradiovidenie: sovremennyj metodologicheskij podhod [Medical heat radiology: a modern methodological approach.]. Nizhnij Novgorod: FGU «NNIITO Rosmedtehnologij». 2008, 184 p.

15. Голованова М. В., Потехина Ю. П. Возможности термодиагностики в медицине. Нижний Новгород: ЗАО «СЕМТехнолоджи»; 2011; 164 с. Golovanova M. V., Potekhina YU. P. Vozmozhnosti termodiagnostiki v medicine [Possibilities of thermodiagnostics in medicine]. Nizhnij Novgorod: ZAO «SEM-Tekhnolodzhi»; 2011; 164 p.

16. Мохов Д. Е., Белаш В. О., Кузьмина Ю. О., Лебедев Д. С., Мирошниченко Д. Б., Трегубова Е. С., Ширяева Е. Е., Юшманов И. Г. Остеопатическая диагностика соматических дисфункций: Клинические рекомендации. СПб.: Невский ракурс; 2015; 90 с. Mokhov D. E., Belash V. O., Kuz′mina Ju. O., Lebedev D. S., Miroshnichenko D. B., Tregubova E. S., Shirjaeva E. E., Yushmanov I. G. Osteopaticheskaja diagnostika somaticheskih disfunkcij: Klinicheskie rekomendacii [Osteopathic diagnosis of somatic dysfunctions: Clinical guidelines]. St. Petersburg: Nevskij rakurs; 2015; 90 p.

17. Scott J., Huskisson E. C. Graphic representation of pain. Pain. 1976; 2 (2); 175–184. https://doi.org/10.1016/0304-3959(76)90113-5.

18. Зеновко Г. И. Термография в хирургии. М.: Медицина, 1998. 168 с. Zenovko G. I. Termografi ja v hirurgii [Thermography in surgery]. M.: Medicina; 1998. 168 p.

19. Мельникова В. П., Мирошников М. М., Брюнелли Е. Б., Воронов В. Г., Гончар Н. В., Козлов О. А. и др. Клиническое тепловидение. Руководство для врачей. СПб.: Государственный оптический институт им. С. И. Вавилова; 1999: 123 с. Mel′nikova V. P., Miroshnikov M. M., Brjunelli E. B., Voronov V. G., Gonchar N. V., Kozlov O. A. i dr. Klinicheskoe teplovidenie. Rukovodstvo dlja vrachej [Clinical thermal imaging. A guide for doctors]. SPb.: Gosudarstvennyj opticheskij institut im. S. I. Vavilova; 1999: 123 p.

20. Густов А. В., Потехина Ю. П., Гафиатуллин И. А., Голованова М. В., Васильченко Н. А. Инфракрасная термометрия как скрининговый метод определения уровня метаболизма головного мозга. Современные технологии в медицине 2010; 2: 32–34. Gustov A. V., Potekhina Yu.P., Gafi atullin I. A., Golovanova M. V., Vasilchenko N. A., Infrared thermometry as a screening method of the brain metabolism level detection. Modern technologies in medicine 2010; 2: 32–34.