The influence of osteopathic correction to the level of stress in patients with cervicobrachialgia

Introduction. For modern people stress is an inevitable part of their life. Unfortunately, it is often assumed that stress is just a transient nervous tension that does not require treatment. This delusion only exacerbates the situation: one stressful situation is replaced by another, and the state of health is constantly deteriorating, and the psychosomatic disorders develop that have various clinical manifestations. Stress also aggravates the course of an existing pathology, and the presence of pathology is in itself a powerful stress factor. It should also be noted that stress is often accompanied by somatic dysfunctions for which osteopathic correction is effective. It is also impossible to imagine a modern person without dorsopathies, often associated with a sedentary lifestyle. Today, approximately 45 % of dorsopathies are in the cervical spine, of which 41.3 % of patients have cervicocranialgia. This pathology is characterized by frequent recurrence and progression, especially in people of the most working age, and it causes a high medical and social significance of cervicocranialgia. Frequent anomalies of the craniocervical zone, extensive fascial, visceral and muscle connections at the regional and global level, participation in the membrane system of mutual tension of the dura mater and suture structures of the skull — all this necessitates an integrated approach to the treatment of patients with cervicocranialgia, including osteopathic correction. All of the above allowed us to suggest that osteopathic correction may influence stress levels in patients with cervicocranialgia.

The goal of research — to study the effect of osteopathic correction on the level of stress in patients with cervicocranialgia in a state of severe psychological stress.

Materials and methods. The study involved 24 patients suffering from cervicocranialgia, characterized by prolonged exposure to severe psychological stress and high levels of cortisol in the blood. The study participants were divided into a control (12 people) and an experimental (12 people) group by the method of simple randomization using a random number generator. Participants in both groups received standard drug treatment for cervicocranialgia: non-steroidal anti-inflammatory drugs, B vitamins, muscle relaxants, angioprotectors and microcirculation correctors. The participants in the experimental group additionally received osteopathic correction. In both groups, before and after the course of treatment, the patients’ osteopathic status was assessed, the stress level was assessed using the PSM-25 psychological stress scale, and the morning blood cortisol level was measured. The obtained results were processed by methods of parametric and nonparametric statistics.

Results. It was found that both the standard drug treatment of patients suffering from cervicocranialgia and the complex treatment with the use of osteopathic correction contribute to a statistically significant decrease in the level of cortisol in the blood (p<0,0001 in the experimental group, p=0,001 in the control group). But only complex treatment, including osteopathic correction, was accompanied by a significant decrease in the level of psychological stress (p=0,001) and the number of regional somatic dysfunctions (p<0,005) in the participants of the experimental group. In the patients of the experimental group, the improvement in all indicators was statistically significantly more pronounced (p <0,01) than in the participants of the control group.

Conclusion. The obtained results demonstrate that the addition of osteopathic correction to the drug therapy of the patients with cervicocranialgia in a state of severe psychological stress gives a pronounced effect of the stress level reducing.

1. Zhuravlev A. L., Sergienko E. A.Stress, burnout, coping in the modern context. M.: Institute of psychology RAS; 2011; 512 p. (in russ.)

2. Kitaev-Smyk L. A. Psychology of stress. M.: Academic Project; 2009; 943 p. (in russ.)

3. Sudakov K. V., Umryukhin P. E. System bases of stress. M.: GEOTAR-Media; 2010; 112 p. (in russ.)

4. Lebedev M. A., Palatov S. Yu., Kovrov G. V. Fatigue and its manifestations. Rus. Med. J. 2014; 22 (4): 282-286 (in russ.)

5. Novitsky V. V., Goldberg E. D. Pathophysiology: Textbook for medical universities. Tomsk: TSMU; 2006; 716 p. (in russ.)

6. Potekhina Yu. Pathogenesis of Somatic Dysfunctions (Local and Regional Levels). Russ. Osteopath. J. 2016; 3-4 (34-35): 91-104 (in russ.). https://doi.org/10.32885/2220-0975-2016-3-4-91-104

7. Scherbatykh Yu. V. Psychology of stress and methods of correction. St. Petersburg: Piter; 2006; 256 p. (in russ.).

8. Buckup K.Clinical study of bones, joints and muscles. Tests, symptoms, diagnosis. M.: Med. lit.; 2010; 320 p. (in russ.)

9. Veselovsky V. P., Mikhailov M. K., Samitov O. S. Diagnostics of spinal osteochondrosis syndromes. Kazan: Kazan State University; 1991; 288 p. (in russ.)

10. Khabirov F. A. Clinical vertebroneurology. Kazan: Meditsina; 2018; 594 p. (in russ.)

11. Haldeman S., Dagenais S. Cervicogenic headaches: a critical review. Spine J. 2001; 1 (1): 31-46. https://doi.org/10.1016/s1529-9430(01)00024-9

12. Jensen R., Stovner L. J. Epidemiology and comorbidity of headache. Lancet Neurol. 2008; 7 (4): 354-361. https://doi.org/10.1016/s1474-4422(08)70062-0

13. Kozlova N. S., Belash V. O. Osteopathic Aspects of Vertebroneurology. Russ. Osteopath. J. 2017; 1-2 (36-37): 105-117 (in russ.). https://doi.org/10.32885/2220-0975-2017-1-2-105-117

14. Wang E., Wang D. Treatment of cervicogenic headache with cervical epidural steroid injection. Curr. Pain Headache Rep. 2014. 18 (9): 442. https://doi.org/10.1007/s11916-014-0442-3

15. Greenman Ph. E. Principles of Manual Medicine. Baltimore: Williams and Wilkins; 1989; 386 p.

16. Gross A. R., Paquin J. P., Dupont G., Blanchette S., Lalonde P., Cristie T., Graham N., Kay T. M., Burnie S. J., Gelley G., Goldsmith C. H., Forget M., Santaguida P. L., Yee A. J., Radisic G. G., Hoving J. L., Bronfort G. Exercises for mechanical neck disorders: a Cochrane review update. Manual Ther. 2016; 24; 25-45. https://doi.org/10.1016/j.math.2016.04.005

17. Prevention and treatment of backpain. A guide for physicians / Eds. F. A. Habirov, N. I. Galiullin, Yu. F. Habirova. Kazan: Meditsina; 2010; 208 p. (in russ.)

18. Khabirov F. A. Muscle pain. Kazan: Knizhnyy Dom; 1995; 208 p. (in russ.)

19. Popeliansky Ya. Yu. Orthopedic neurology (vertebroneurology): A guide for physicians. M.: MEDpress-inform; 2011; 672 p. (in russ.)

20. Petrischev А., Mokhov D., Shakirov A. Osteopathic Treatment of Patients Presenting Cervicalgia. Russ. Osteopath. J. 2016; 1-2 (32-33): 36-43 (in russ.). https://doi.org/10.32885/2220-0975-2016-1-2-36-43

21. Flaum R. A., Belash V. O. Structure of Dominant Somatic Dysfunctions in Patients with Tension-type Headache. Russ. Osteopath. J. 2017; 3-4 (38-39): 26-30 (in russ.). https://doi.org/10.32885/2220-0975-2017-3-4-26-30

22. Tarasova A. V., Potekhina Yu. P., Belash V. O., Klassen D. Ya. The application of infrared thermography for the objectification of somatic dysfunctions and osteopathic correction results. Manual Ther. J. 2019; 4 (76): 35-41 (in russ.)

23. Belash V. O., Mokhov D. E.Osteopathic methods of correction in the complex therapy of vertebral artery syndrome. Manual Ther. J. 2017; 1 (65): 76-77 (in russ.)

24. Belash V. O., Mokhov D. E., Tregubova E. S. The use of the osteopathic correction for the combined treatment and rehabilitation of the patients presenting with the vertebral artery syndrome. Probl. Balneol. Physiother. Exercise Ther. 2018; 95 (6): 34-43 (in russ.) https://doi.org/10.17116/kurort20189506134

25. Mokhov D. E., Miroshnichenko D. B. General osteopathic treatment: A textbook. SPb.: Publishing house of the I. I. Mechnikov’ NWSMU; 2018; 80 p. (in russ.)

26. Mokhov D. E., Belash V. O. Methodology of clinical osteopathic examination: Study guide. St. Petersburg: Izd-vo SZGMU im. I. I. Mechnikova; 2019; 80 p. (in russ.)

27. Mokhov D. E., Aptekar I. A., Belash V. O., Litvinov I. A., Mogelnitsky A. S., Potekhina Yu.P., Tarasov N. A., Tarasova V. V., Tregubova E. S., Ustinov A. V. The basics of osteopathy: A textbook for residents. M.: Geotar Publishing Group; 2020; 400 p. (in russ.)

28. Endocrinology: National guide / Eds. I. I. Dedova, G. A. Melnichenko.M.: GEOTAR-Media; 2019; 1112 p. (in russ.)

29. Lemyre L., Tessier R. Measurement of psychological stress: To feel stressed. Canad. J. Behav. Sci. 1988; 20 (3): 302-321. https://doi.org/10.1037/h0079945