Vol 5, No 1 (2020)
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Published online: 2020-03-31

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

Witold Miecznikowski1, Paweł Kiczmer2, Karolina Cygan3, Krzysztof Starszak2, Elżbieta Świętochowska2
Medical Research Journal 2020;5(1):34-40.


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.

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