Pathogenetic effect of osteopathy in chronic tension headache
Miroshnichenko D.B.¹, Mokhov D.E.², Rachin A.P.<sup>1

1</sup> National Medical Research Center of Rehabilitation and Balneology, Moscow
² North-West State Medical University named after I.I. Mechnikov, St. Petersburg

The article considers the features of using osteopathy in the treatment of patients with chronic tension headache (CTH).
Aim: to evaluate the effectiveness of osteopathy influence on the dynamics of clinical parameters of cephalgia and psychological status, as well as polysynaptic reflex excitability of the brainstem of patients with CTH.
Patients and Methods: 108 patients with CTH participated in the study, the average age was 38.4-0.64 years. To study the effectiveness of osteopathy, all patients with CTH were randomly divided into the main group, the comparison group and the control group. The number of osteopathy sessions in the main group was determined by the dynamics of the clinical and neurological status and averaged 4-8 procedures per course, with a frequency of 1-2 times per week. In the comparison group, treatment included standard CTH therapy with classical antidepressant amitriptyline in an individual dose of 50 to 100 mg / per day. Along with the drug therapy, all patients in this group received 6-8 sessions of manual therapy. The control group consisted of 22 healthy volunteers. 
Results: all patients with CTH complained of symmetrical, compressing, aching, non-throbbing moderate headache. In 94.8% of the observations the CTH was accompanied by manifestations of psycho-emotional dysfunction. The initial results of the osteopathic examination in the study groups of patients with CTH revealed a lot of different somatic dysfunctions. It should be emphasized that there were no significant differences in the number and types of somatic dysfunctions among these groups. In the main group, against a background of osteopathic treatment, there was a significant decrease in the frequency of headaches (p <0.05), a decrease in the intensity of headaches (p <0.05), a decrease in headaches duration (p <0.05), and also a significantly greater dynamics on the anxiety / depression scale (p <0.05), indicating a decrease in emotional and affective disorders. 
Conclusion: osteopathy provides the normalization of polysynaptic reflex excitability of the brainstem, which is a marker of the functional state of the inhibitory control mechanisms of the antinociceptive system. Osteopathy can be an appropriate method of choice for the treatment of CTH.

Key words: chronic tension headache, osteopathy, blink reflex, polysynaptic reflex activity of the brainstem, somatic dysfunction.
For citation: Miroshnichenko D.B., Mokhov D.E., Rachin A.P. Pathogenetic effect of osteopathy in chronic tension headache // RMJ. 2017. № 21. P. 1533–1536.