Osteopathic treatment of cervicalgia in dentists experiencing prolonged professional overloads

Abstract

Introduction. Among dentists, the prevalence of major occupational diseases is higher than among medical professionals in general. Thus, under the influence of professional physical exertion, functional and structural changes occur in the joints, changing their mobility. More than 50 % of dentists have various types of musculoskeletal pathology, and at least half of them are disorders in the cervical spine. A number of studies have demonstrated the effectiveness of the osteopathic correction in the treatment of cervical pain syndromes. However, the possibility of osteopathic correction in the treatment of occupational diseases among medical workers has not been specifically considered.The aim of the study is to evaluate the effectiveness of osteopathic treatment of cervicalgia in dentists experiencing prolonged professional overload.Materials and methods. Under observation there were 30 patients — dentists (13 men and 17 women, age 35–55 years) with a previously established diagnosis of Cervicalgia (duration of the disease 1–5 years). The patients were divided into the main (15 people) and control (15 people) groups. The control group of patients received a set of physical therapy exercises. The main group of patients additionally received three sessions (1 every 10 days, duration 45 min) of osteopathic correction. Before and after the course of treatment, the detection frequency of somatic dysfunctions, life quality (a short version of the World Health Organization questionnaire WHOQOL-BREF was used), pain syndrome severity (by a 100-point visual analog scale), and active movements volume in the cervical spine (by a medical goniometer) were evaluated.Results. At the study beginning in the both groups there were most often detected somatic dysfunctions in the following regions: cranio-cervical region (sphenobasillary synchondrosis (SBS), С0–I, СII–III and СVI–VII vertebralmotor segments (VMS) of the cervical spine), pelvic region (sacrum, pubic joint), thoracic region (diaphragm, sternoclavicular joint, ThVI–VII and ThII–III VMS of the thoracic spine). After the treatment, positive statistically significant (p<0,05) dynamics was observed in the main group for all of the above dysfunctions, and in the control group only for disorders of SBS, VMS С0–I, sacrum, VMS ThVI–VII. There were significant (p<0,05) difference between groups by the detection frequency of SBS, pubic articulation and diaphragm dysfunctions. After the treatment, patients in both groups had a statistically significant (p<0,05) improvement in the life quality by the «physical and mental well-being» domain, and in the main group these changes were statistically significantly (p<0,05) more pronounced. After the therapy course completion, the pain intensity in patients of the main group decreased to an average of 6 points, in 13 patients the pain symptom was completely eliminated. In the control group, the pain syndrome intensity decreased to an average of 35 points, none of the patients had a complete pain absence. The differences between the groups were statistically significant (p<0,05). After the therapy course, a statistically significant (p<0,05) increase in flexion, extension, lateroflexion to the right and left, rotation to the left was noted in the main group; and in the control group the significant positive dynamics was noted with respect to flexion and lateroflexion in both directions, rotation to the left. The groups began to differ significantly (p<0,05) by the volume of lateroflexion to the left and inflection in the cervical spine.Conclusion. The obtained data allow us to recommend the use of osteopathic correction in the treatment of occupational diseases of the cervical spine in dentists.