Introduction
Rheumatoid arthritis (“RA”), whose characteristics are chronic inflammation and chronic pain, accompanies autonomic nervous system dysfunction. It is reported that thermo-spinal massage affects relief of chronic pain and recovery of autonomic nervous system (“ANS”). Therefore, thermo-spinal massage treatment was applied to a rheumatoid patient with chronic pain and ANS dysfunction which resulted in a remarkable reduction in chronic pains.
Case presentation
Thermo-spinal massage treatment is applied to a 43 years-old female rheumatoid patient who were diagnosed with chronic pain and ANS dysfunction. She complained of pains in finger joints caused by RA, chronic pains in both shoulders and neck, and headache. Her pains tend to reach average 5 to 6 of visual analogue scale (VAS) and, several times a day, were aggravated with 7 to 9 of VAS. Narcotic analgesics (opioid) were administered to control pain, but there was no improvement. Thus, she was treated with 40 minutes of thermo-spinal massage 2 times a day for 20 weeks. During the treatment, her assessed average pains were dropped to 1 to 3 of VAS and aggravation of pain was starting to decrease from 10th week and did not occur since 12th week. In addition, the use of opioid has reduced and has not been administered since 12th week. Upon completion of 20 weeks-treatment, we conducted heart rate variability (HRV) analysis before, during, and after treatment for thermo-spinal massage treatment (measure 1) and for bed-resting (measure 2). In measure 1, a remarkable increase in parasympathetic activity showed and, after treatment, such increase was sustained. However, in measure 2, after treatment, it was confirmed that sympathetic activity increased more than before treatment.
Discussion
Parasympathetic activity is induced by thermo-spinal stimulation, which activates the ventral periaqueductal gray substance. Through this, the descending serotonin pathway and noradrenaline pathway, which have opiate analgesic effects, are thought to have caused chronic pain relief effects. |
