Abstract：
BACKGROUND: Neck pain is a leading cause of disability worldwide. Visceral referred pain is a common form of disease-induced pain, with visceral nociception being referred to somatic tissues.
OBJECTIVE: The aim of this case report was to evaluate the immediate and long term effects of a novel osteopathic visceral technique (OVT) on pain and cervical range of motion (CROM) in a patient with nonspecific neck pain (NS-NP).
METHODS: A case of a 47-year-old female suffering with NS-NP for four months. The patient had sought physiotherapy treatment several times, and occasionally used anti-inflammatory medication to relieve symptoms. The patient presented muscle cervical tenderness and hyperalgesia over the spinous processes of C3-C4 spinal segments with limited CROM. A novel osteopathic visceral manipulation (OVM) technique was applied in the epigastric region targeting the pancreas. Immediately after the treatment, the patient reported reduction in pain evaluated with the numerical evaluation scale (NRS), and a clinically significant increase in pressure pain threshold (PPT) in C3 spinous process. Improvement in CROM was also observed. The post-treatment improvements have been maintained at 1-month of follow-up assessment.
CONCLUSIONS: A single OVT was effective in reducing cervical pain and increasing CROM in a patient with NS-NP caused by a viscerosomatic reflex. The results of this case study provides preliminary evidence that OVM can produce hypoalgesia in somatic tissues with segmentally related innervation. This finding encourages future research to gain a better understanding of the mechanisms of regional inhibitory interdependence involving the viscerosomatic reflexes of OVM.
OBJECTIVE: The aim of this case report was to evaluate the immediate and long term effects of a novel osteopathic visceral technique (OVT) on pain and cervical range of motion (CROM) in a patient with nonspecific neck pain (NS-NP).
METHODS: A case of a 47-year-old female suffering with NS-NP for four months. The patient had sought physiotherapy treatment several times, and occasionally used anti-inflammatory medication to relieve symptoms. The patient presented muscle cervical tenderness and hyperalgesia over the spinous processes of C3-C4 spinal segments with limited CROM. A novel osteopathic visceral manipulation (OVM) technique was applied in the epigastric region targeting the pancreas. Immediately after the treatment, the patient reported reduction in pain evaluated with the numerical evaluation scale (NRS), and a clinically significant increase in pressure pain threshold (PPT) in C3 spinous process. Improvement in CROM was also observed. The post-treatment improvements have been maintained at 1-month of follow-up assessment.
CONCLUSIONS: A single OVT was effective in reducing cervical pain and increasing CROM in a patient with NS-NP caused by a viscerosomatic reflex. The results of this case study provides preliminary evidence that OVM can produce hypoalgesia in somatic tissues with segmentally related innervation. This finding encourages future research to gain a better understanding of the mechanisms of regional inhibitory interdependence involving the viscerosomatic reflexes of OVM.
摘要：
背景：颈部疼痛是全球残疾的主要原因。内脏性疼痛是一种常见的疾病引起的疼痛，内脏伤害性是指体细胞组织。
目的：本病例报告的目的是评估一种新型骨病内脏技术（OVT）对非特异性颈痛（NS-NP）患者疼痛和颈椎活动度（CROM）的近期和长期影响。
方法：一例47岁女性患有NS-NP4个月。病人多次寻求理疗,偶尔使用消炎药缓解症状。患者在CROM有限的C3-C4脊柱节段的棘突上表现出肌肉宫颈压痛和痛觉过敏。一种新颖的整骨内脏操作（OVM）技术被应用于针对胰腺的上腹部区域。治疗后立即，患者报告用数值评估量表(NRS)评估疼痛减轻，C3棘突压力痛阈值（PPT）的临床显着增加。还观察到CROM的改善。在1个月的随访评估中维持了治疗后的改善。
结论：在内脏反射引起的NS-NP患者中，单一OVT可有效减轻宫颈疼痛并增加CROM。该病例研究的结果提供了初步证据，表明OVM可以在具有节段相关神经支配的躯体组织中产生痛觉减退。这一发现鼓励未来的研究更好地了解涉及OVM内脏反射的区域抑制性相互依存的机制。
目的：本病例报告的目的是评估一种新型骨病内脏技术（OVT）对非特异性颈痛（NS-NP）患者疼痛和颈椎活动度（CROM）的近期和长期影响。
方法：一例47岁女性患有NS-NP4个月。病人多次寻求理疗,偶尔使用消炎药缓解症状。患者在CROM有限的C3-C4脊柱节段的棘突上表现出肌肉宫颈压痛和痛觉过敏。一种新颖的整骨内脏操作（OVM）技术被应用于针对胰腺的上腹部区域。治疗后立即，患者报告用数值评估量表(NRS)评估疼痛减轻，C3棘突压力痛阈值（PPT）的临床显着增加。还观察到CROM的改善。在1个月的随访评估中维持了治疗后的改善。
结论：在内脏反射引起的NS-NP患者中，单一OVT可有效减轻宫颈疼痛并增加CROM。该病例研究的结果提供了初步证据，表明OVM可以在具有节段相关神经支配的躯体组织中产生痛觉减退。这一发现鼓励未来的研究更好地了解涉及OVM内脏反射的区域抑制性相互依存的机制。
