Cortisol, testosterone, and pain levels among patients undergoing McKenzie therapy and suboccipital relaxation

Abstract

Sedentary lifestyle and the development of consumer electronics, often associated with a faulty posture, are widespread factors contributing to cervical spine dysfunction (CSD). The purpose of our study is to compare two methods of physical therapy of CSD: suboccipital relaxation and the McKenzie method. Their effect on perceived pain level and life quality was assessed using VAS and NDI scores. Serum levels of biochemical stress indicators like testosterone and cortisol were also evaluated. Eighty-six adult patients were divided into two groups: Group A and Group B. Group A included 42 patients treated using the McKenzie method. Group B consisted of 44 patients who underwent suboccipital relaxation. The therapy in both groups included three treatment sessions over a six-week period. Testosterone and cortisol levels were assessed using the ELISA technique. Pain evaluation was performed using the Visual Analogue Scale (VAS). The disability level was evaluated with the Neck Disability Index (NDI). In both groups, a similar improvement in VAS and NDI scores was observed. A distinct cortisol level decrease in patients subjected to the suboccipital relaxation was noticed, while the McKenzie method did not affect cortisolaemia significantly. We did not notice any difference in testosterone levels between the two groups. Both treatment methods contributed towards clinical improvement in our patients, represented by the drop in VAS and NDI scores. We also observed a biochemical improvement: decreased cortisol level in the group treated with suboccipital relaxation. Due to the important role of testosterone and cortisol in the pathogenesis of chronic pain, our study should be the pilot experience on their use as markers in CSD.