Assessment of induced pain levels in local and regional somatic dysfunction in patients with cervical spine dorsopathy

Introduction. The specifi c object of osteopathic treatment is somatic dysfunction (SD). However, if previously all osteopathic diagnosis and correction was reduced to the isolation of certain local dysfunctions, now there are signifi cant changes in the paradigm of osteopathy. SD in the body can manifest at different levels — local, regional and global. And from the position of physiology, three components can be conditionally distinguished in SD — biomechanical, hydrodynamic and neurodynamic. At the same time, it seems extremely necessary to conduct a number of studies that would not only confi rm the validity of the allocation of SD at different levels of the whole organism but also allow to objectify palpatory fi ndings of the doctor.
The aim of the study: to evaluate the level of induced pain in the areas of local and regional SD in patients with cervical dorsopathy.
Materials and methods. The cross-sectional study was conducted on the basis of the medical clinic LLC «Mokhov Institute of Osteopathy» (Saint-Petersburg) in the period from September 2018 to September 2022. 230 patients diagnosed with dorsopathy were under observation. All patients were assessed for osteopathic status, degree of pain syndrome severity using visual analogue scale (VAS), pressor algometry with assessment of the level of induced pain and degree of pain tolerance.
Results. According to the results of osteopathic diagnostics the patients were divided into three groups: with regional SD (structural component) at the level of the neck (group 1 — 105 people), with local SD of separate vertebromotor segments at the level of the cervical spine (group 2 — 68 people) and without SD of the musculoskeletal system at the level of the neck (group 3 — 57 people). It turned out that in patients with regional SD (neck region, structural component) the level of local pain (induced pain) was statistically signifi cantly higher (p<0,01) than in patients with local SD at this level or without it at all. According to the rest of the obtained data, the studied groups of patients in terms of pain severity (VAS) as well as pain tolerance had no signifi cant differences.
Conclusion. The results of pressor algometry showed that in the area of regional biomechanical disturbance at the level of the neck in patients with dorsopathy there is an increase in pain compared to patients with local SD at this level or without it at all. The obtained data confi rm the validity of different levels of dysfunction and also indirectly objectify the neurodynamic component of SD.

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