Neuropsychological indicators in patients with cervical dorsopathy and the influence of non-pharmacological treatment on them

Introduction. The main clinical manifestation of dorsopathy is pain syndrome of varying degrees of expression. Conventional treatment regimens focus primarily on pain management, with an emphasis on drug therapy.

Taking drugs is always associated with a certain risk, but drugs are increasingly administered in larger quantities. In recent years, there has been a justified increase in the interest of specialists from different fields to nonpharmacological methods of pain treatment. It is also worth noting that the attention of clinicians sometimes misses the fact that pain syndromes, primarily chronic, are very closely related to the psycho-emotional state of patients, which must be taken into account in the course of treatment. At the same time, current studies evaluating neuropsychological indicators and their dynamics against the background of treatment, especially non-pharmacological, in patients with dorsopatities are few. All of the above and predetermined the purpose of this work.

The aim of the study: to study neuropsychological indicators and their dynamics against the background of nonpharmacological treatment in young patients with cervical dorsopathy.

Materials and methods. The prospective randomized controlled study has been conducted since September 2018 to September 2022 at the clinical base of the Department of osteopathy I. I. Mesnikov NWSMU. 631 patients with a diagnosis of dorsopathy were under observation. 169 people dropped out of the study for various reasons. Thus, a group of 462 patients between the ages of 18 and 45 was formed. Depending on the treatment methods used, all patients monitored with randomized controlled trials were divided into three groups: group 1 (n=228) received osteopathic correction (OK); group 2 (n=124) received reflexotherapy (RT); group 3 (n=110) received osteopathic correction and reflexotherapy. Treatment approach, both osteopathic and reflexotherapy, in each patient was individual and based on the results of previous diagnosis. All patients were assessed prior to the start of treatment and 7–10 days after the end of it, the severity of pain intensity assessment (Visual Analog Scale, VAS), asthenic condition (ShAS test), well-being, activity, mood (SAN questionnaire) was evaluated.

Results. Before treatment, the patients examined were characterized by a moderate level of pain syndrome, mainly presence of mild and pronounced asthma and predominance of mood variability. According to these indicators, patients of the observed groups had no statistically significant differences (p>0,05). After treatment, all groups of patients showed a statistically significant positive trend (p<0,05) for all evaluated indicators. However, it was found that statistically more pronounced (p<0,05) reduction of the pain syndrome was observed in patients 1 (OK only) and 3 groups (combined use of OK and PT), and more pronounced depression in patients 1 (OK only).

Conclusion. For young patients with cervical dorsopathy in the clinical picture in addition to pain syndrome is characteristic the presence of moderate and pronounced asthma, as well as the prevalence of mood variability. Osteopathy and reflexotherapy, both in the form of monotherapy and combined use, have demonstrated significant clinical effectiveness (control of pain syndrome, asthenia condition, improvement of mood). This makes it possible to recommend the application of these non-pharmacological approaches in the therapy of patients with dorsopathy, especially when the use of pharmacological treatment for some reason becomes impossible.

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