Rationale for the use of osteopathic correction in the treatment of patients with chronic lower limb vein disease
Authors: Shmeleva A. S. , Mizonova I. B. 
Published: June 2020

Introduction. Despite the constant improvement of treatment methods, chronic lower limb vein disease (CLLVD) remains an urgent and not completely solved problem. Therefore the search for new methods of this disease treatment is actual. The effectiveness of osteopathic treatment of patients with CLLVD has been shown in recent years. But despite this the use of osteopathic treatment in this area has not been widely used today because further research, generalization of results and creation of an evidence base are required.

The goal of research— is to substantiate the possibility of osteopathic treatment for patients with CLLVD C1–C3 (according to the international classification system CEAP).

Materials and methods. The study involved 20 patients suffering from C1–C3 CLLVD. The main group (10 people) receiving osteopathic treatment and the control group (10 people) receiving standard treatment were formed by simple randomization. At the beginning and the end of the study there were evaluated osteopathic status of study participants, changes in pain intensity by visual analogue scale (VAS), changes in quality of life according to the questionnaire CIVIQ (Chronic Venous Insufficiency Quality of Life Questionnaire), and changes in the diameter of the saphenous veins of the lower extremities.

Results. Osteopathic examination of patients with CLLVD C1–C3 (according to the CEAP classification system) prior to the treatment allowed to establish the presence of somatic dysfunctions of the regional (lumbar and pelvic regions, structural and visceral), and local (diaphragm, sigmoid and caecum) level. The use of osteopathic correction in the main group compared with medical treatment in the control group leads to a statistically significant (p<0,05) decrease in the number of regional biomechanical dysfunctions of the lumbar and pelvic region, visceral components, and local somatic dysfunction of the diaphragm. The use of osteopathic correction in the main group leads to a statistically significant (p<0,01) more expressed reduction in pain intensity and improved quality of life compared to the control group receiving medication. Both osteopathic correction and standard medical treatment are accompanied by a significant (p<0,05) decrease in the diameter of the small saphenous vein of the affected limb, as well as the diameter of the large saphenous vein (only in the group that received osteopathic correction). There were no cases of adverse treatment outcome.

Conclusion. The infl uence of the somatic dysfunctions osteopathic correction on the development of chronic lower limb venous disease (classes C1–C3 according to the CEAP classification system) was studied. It was shown that this infl uence is not inferior to the standard medical method of treatment. The patients′ life quality improves, the experienced pain level decreases, and the subcutaneous veins diameter decreases. In comparison with the control group using the drug method of treatment, there is a statistically significant more expressed decrease in the number of somatic dysfunctions. The obtained results suggest the possibility of osteopathic correction using for C1–C3 class CLLVD according to the international classification system CEAP.