WALKING THE PATHS OF WAR: CONCUSSION AND PTSD AS SEEN THROUGH THE EYES OF A MANUAL THERAPIST

Abstract

The military conflict in Ukraine has caused a significant number of concussions, bringing to light the lack of a single standardized approach to the treatment of their long-term effects, both in our country and anywhere else in the world. The purpose of this monograph is the author's desire, based on his many years of prior experience treating the consequences of mTBI and combat-related concussions, to offer, in addition to the other methods described, his own perspective on how to address the problem using manual therapy techniques in combination with shock wave therapy. An analysis of the sources reviewed shows that treatment for the effects of mTBI is symptomoriented, but the actual foundation of such treatment is very limited and focuses on “prevention through education”. Typically, mTBI victims exhibit comorbid PTSD and depression in their anamnesis, which complicates both the progression of each individual condition as well as the course of the entire complex of these pathologies. According to NICE recommendations, the treatment for the consequences of mTBI and PTSD includes three methods: Selective Serotonin Reuptake Inhibitors (SSRIs), Eye Movement Desensitization and Reprocessing (EMDR), and Trauma-Focused Cognitive-Behavioral Therapy (TFCBT), the latter being the most effective one. Vestibular Rehabilitation (VR) is also regarded as a specialized approach to addressing vestibular disorders. Foreign and domestic sources recommend medication therapy aimed at eliminating specific symptoms, psychological therapy, manual & physiotherapeutic techniques, therapeutic exercise, and massage. Manual therapy and chiropractic care have also shown significant success in combating the long-term effects of mTBI. The methods proposed so far for treating the long-term effects of mTBI enable combating psychoneurological and traumatic symptoms, remedying to some extent emotional disturbances, and providing cognitive correction and rehabilitation. However, they do not constitute a holistic concept for regenerating the human body and returning it to a state that most closely approximates its condition before the concussion. This study has analyzed and confirmed, through over 120 specific clinical cases, the feasibility of a novel method for treating remote consequences of concussion and PTSD resulting from combat-related traumatic brain injury. The method consists in the combined application of manual therapy techniques in conjunction with shock wave therapy. Both manual and shock wave therapy can independently address many challenges in treating these pathologies, yet their integrated application within a unified methodology amplifies the efficacy of each approach, creating a synergy that yields a qualitatively superior and significantly more meaningful clinical outcome. The novelty of the method lies in the synergistic combination of two recognized methods of treatment. The simplicity, time-efficiency, non-invasive nature, affordability, and effectiveness of this particular treatment when compared to the time-consuming nature, costliness, and limited effectiveness of other treatment methods, including medication therapy, make its relevance and validity outright obvious.