W, N. Dudley, DC Howell, Michigan
Dr W. N. Dudley is a graduate of the Palmer College of Chiropractic in Davenport, Iowa. A member of the American Chiropractic Association and the Michigan State Chiropractic Association. he has had several professional papers published in the ACA Journal. He is in private practice at 120 State Street, Howell, Michigan 48843.
Thermographic studies of the human back along with thermal measurements are presented.
The chiropractic profession has used heat-sensitive devices for many years1,2 to detect problems in patients. The area viewed has usually been proximal to the spine. Currently, there are a few devices which have come into use in other areas of examination.3 One device which may prove to be of considerable merit is thermography. Thermography has a rapid scan and photographic recorder to aid in maintaining an adequate record of change, if in fact, any change has occurred. It is not a device that lends itself to offhand use since the equipment is costly. The information which thermography provides is not completely understood, but it is felt that the use of thermographic equipment is efficacious.4,5 Having used the machinery6 for some time, this author feels that thermography can provide considerable information to the chiropractor about his patients.
Thermographic scans are rapid and accurate. The area to be scanned can be any heat-producing object. For this investigation the human back was used. No I precautions are needed since the device detects emitted heat and does not produce radiation nor is it invasive. No unusual preliminaries are needed since the object to be scanned can be at room temperature, and, as long as the area scanned has not been contaminated by any external temperature alterations, the results should be accurate. This equipment can measure and record variances as fine as .250C and minimal training is needed to operate the device.
In the following films black is cool and the whitest area is warmest. In Figure 1, a young male is seen with some upper dorsal discomfort because of hyperextension as a result of throwing a baseball. The left low back displays "cool" in the possible outline of the latissimus dorsi but does not produce a symptom. Overall thermal measurement is 20C from the warmest point to the coolest. Although the right shoulder is warmer, the discomfort is in the left arm and shoulder.
FIGURE 1.
FIGURE 2.
In Figure 2, the right levator scapuia and trapezius are the warmest in this male and this is a common finding. That is, there may be, unilateral increase in heat at the upper dorsal area with only moderate variables below.
These two films provide some information worth discussing. First, the spine itself will often be the warmest area of the back and the thermal variance from coolest to warmest is usually 20C maximum7 when measurement is made from the sacral to the upper dorsal area. The cervical area is deleted be contracting poorly. Specific muscle testing confirmed that conclusion. The cool pad at the first dorsal may be a result of a mild osteoporotic kyphosis.
Figure 5 demonstrates mottling. The significance is not known. There is an acute neck injury and thermal elevation at the right upper kapezius and levator scapula.
FIGURE 3.
FIGURE 4.
Figure 6 shows unusual coolness of the spine at the dorsal area and the insertion of the rhomboids bilaterally. Patient was severely jaundiced and had under-gone cobalt therapy. He died three months later as the result of a hepatic carcinoma.
FIGURE 5.
FIGURE 6.
In Figure 7, the left levator scapula is very tender and 10C warmer than the right. The fat pads at the lower rib cage distort the thermal patterns but the overall variable was only 20C. The warmest portion of the spine was of course the sacral area. Some investigators feel that this is a "burned out" sacrum.8 The author does not hold that thermal gradients can be recognized on these films. The measurement is done prior to taking the film by means of isobaric measurement of the oscilloscopic screen, and the films are made to confirm the general pattern of involvement.
In Figure 8, a female displays a bilateral weak latissimus dorsi upon testing which is also shown on thermography.
FIGURE 7.
FIGURE 8.
Thermographic examination of faulted neurologic dermatomes is not always fruitful. No specific dermacause of blockage by the hair of thermal measurements. It is not common to note great thermal increases in the spine unless there is underlying pathology of the bone.8,9 To examine a human back thermographically and find no variables is uncommon. Since there are stresses, and a person must adjust to those stresses, it would seem to necessitate a change in the muscular contraction and therefore alter any symmetery that would be seen without such stress. Therefore, asymmetrical patterns would be expected.10
Figure 3 depicts a young male with no pathology of the bone by x-ray standards, but he has a left scoliosis of the dorsal spine involving the second to the sixth dorsal. The thermal variance or coolness to the right side of the spine could surely be attributed to the non-function of the underlying musculature when compared to the left, and the heat of the left side could be attributed to the additional contraction of the musculature resulting from the scoliotic side. By measurement there is less than a 20C difference overall. This would seem to confirm the hyper-hypo contraction concept.11
In Figure 4, the spinal column of this female exhibits a cool area at the lower dorsal section. The patient complained of pain in the left shoulder and that area is coolest. The coolest area is over the left dorsal but apparently the entire trapezius on the left is
tome can be seen as faulted on thermographic examination of the back which would concur with the neurologic examination. It seems the dermatome must be grossly faulted with extensive involvement into the leg or legs before a thermal variable would show.5,11 Perhaps innervation of the several muscles that form the dermatome were too varied but at present the attempt was unsuccessful for specific delineation of a dermatome.
When a subluxation exists it causes unequal contraction of the muscles.10,12 This unequal contraction should be observable by heat-detecting equipment. If thermography has merit it is in this area to determine not the primary subluxation but rather the effects of that subluxation. Then the subluxation can be traced, corrected by an adjustment, and the imbalance of the nervous system arrested. Frequent alteration of the upper dorsal heat pattern has led to other companion signs being noted. For example, the Adsons sign is always positive on the same side as the elevation of temperature of the levator scapula and some parts of the trapezius.13 If the patient is adjusted to remove the subluxation of the cervical spine and rescanned the temperature would become nearly equal. Therefore, it is easy to note on almost all occasions following adjustments an improvement of the muscular system function and a profound prolonged effect upon the vascular system.
References
1. Aarons, M. W.; "Diagnostic Instruments,"ACA Journal, Vol 8, 1974, pS-49.
2. Adelman, G.:"Infrared Photography," Science Review of Chiropractic, Vol 1, No 1,1964, p 31.
3. Dudley, W, N.: "Thermography,"ACA Journal, Vol 8, 1974, P S-30.
4. Raskin, M. M.; Martinez-Lopez, M., Sheldon, J. I.: "Lumbar Thermography in Discogenic Diseases,"Radiology,Vol 119 No 1, 1976, p 149.
5. Zohn, D. A., and Mennell, J. M.:Musculoskeletal Pain, Little, Brown and Co, 1976.
6. Dudley, W. N., and Miller, G. L.: "Thermography and the Body," ACA Journal, Vol 7,1973, p S-30.
7. Yematsu, S.: Medical Thermography, Theory and Clinical Application, Brentwood Pub, 1976. 8. Raskin, M. M.: Thermography in Low Back Diseases, Medical Thermography, Theory and Clinical Applications, Brentwood Pub Co, 1976.
9. Ching, C., and Wexler, C. E,: "Peripheral Thermographic Manifestations of Lumbar Disc Disease," American Thermographic Society Meeting, October 1977.
10. Homewood, A. E.: Neurodynamics of the Vertebral Subluxation, Chiropractic Pub, 1968.
11. Dudley, W. N.: "Extremity Thermography and Low Back Pain," ACA journal, Vol 11, 1977, p S-29.
12. Dudley. W. N.: "Facial Thermography and Adjustment, ACA Journal, August 1974, p 54.
13. Dudley, W. N.: "Findings Using the Adson Sign,"ACA Journal, Vol 6, 1972, pS-87.
The ACA Journal of Chiropractic November 1978