OBJECTIVES 1) To determine whether the osteopathic manipulation of T8 to T12 hypo mobile vertebrae during a tonsillitis episode without antibiotic treatment, corresponds with a decrease of the number of recurrences in the following year. 2) To determine whether this manipulation corresponds with the total resolution of the symptoms in less than 24 hours or in less than 48. 3) To determine which of the T7 to T12 vertebrae shows a somatic dysfunction in the tonsillitis episodes. 4) To determine if there is any association between the treatment results and any of the variables controlled in this study (sex, age, number of previous episodes, dysfunction of upper, medium and lower cervicals…).
METHODOLOGY: Experimental, longitudinal and mixed (prospective-retrospective) design. Convenience sampling. All the cases that come for treatment of diagnosed tonsillitis are included, once the criteria of inclusion and exclusion have been applied. These cases have been studied in the private practices of L.B.M. (in Jaen) and of the author of this study (in Cáceres), between 1-11-1997 and 30-6-2002. After filling in the questionnaire and signing the informed agreement, hypo mobile vertebrae (from T7 to T12) are diagnosed using Mitchell’s test and the most hypo mobile are manipulated using one or more of four osteopathic techniques: only one with previous tensing up (standing) and three with thrust (one standing and three in supine). All the manipulations and all the changes in the symptomatology of tonsillitis are recorded in the first week and every three months recording also the recurrences, which can be treated again using this protocol.
RESULTS: Total number of cases: 75 (49 women, 26 men). Age: 2 to 61 (41 adults, 34 children). 54 of these cases received only manipulative treatment once. The means of tonsillitis episodes in the previous year was 5, 15 episodes/patient/year. Of the tested vertebrae, the most frequently, hypo mobile were T10 (65% of the cases) and T9 (64%). Regarding the symptomatology of tonsillitis, the results in the short term after the first session were: excellent (total recovery of symptoms in less than 24 hours) in 42 cases (56 %), good (total recovery in 48 hours) in 15 cases (20 %), medium (partial recovery in less than 24 hours needing medical conventional treatment) in 6 cases (8%), and bad (no improvement) in 12 cases (16%). Regarding the results, there haven’t been significative differences between the four techniques of manipulation. In 28 cases, other otorhinolaryngological symptoms improved, which were not tonsil-related. Out of the controlled variables, we only observed association between the somatic dysfunction of upper cervical and bad results in the short term (comparing good and bad results), Fisher exact p value of 0,0169; and medium cervicals and results in the short term, Fisher exact p value of 0,0231. Long term results (12 months) of the 65 first cases: 35 (53, 85%) didn’t have any tonsillitis episodes and 30 (46, 15%) suffered some recurrences. Three cases were tonsillectomised in the following year. The rest of cases (62) improved from having 298 episodes the previous year (means = 4, 81 episodes / patient / year) to having 90 episodes the year following the manipulation (means = 1, 45 episodes / patient / year). Having the Wilcoxon-test for pair samples been applied, there is statistically significative difference; p value < 0, 0001. CONCLUSIONS: During a tonsillitis episode, the osteopathic manipulation of hypo mobile vertebrae T8 to T12 is an effective treatment for remission of the episode, without using antibiotics, in less than 24 hours (in more than half the cases in this study) or in less than 48 hours (in more than 3/4 of the cases in this study), and for the prevention of recurrences in the following year. In the studied cases, the most hypo mobile of T7 to T12 vertebrae, were T10 and T9. Out of the controlled variables, we only observed association between the somatic dysfunction of upper or medium cervical and bad results in the short term. In the face of the promising results achieved with this manipulative treatment, further studies are necessary for accurate indications and limitations, as well as for its action mechanisms.