Infrared Thermography and Its Clinical Application in Osteopathy

Introduction

Osteopathic Manipulative Treatment (OMT) focuses on addressing somatic dysfunctions through manual techniques aimed at restoring mobility, relieving pain, and improving physiological function. In recent years, there has been growing interest in integrating objective tools to complement clinical practice. Among them, infrared thermography (IT) stands out as a non-invasive, fast, and radiation-free method that allows visualization of superficial thermal changes associated with inflammatory processes, autonomic alterations, or movement restrictions. This technology offers a quantifiable view of the patient’s physiology, making it particularly useful in osteopathic care (Sternat & Mikel, 2017).

Physiological Basis and Underlying Mechanisms

IT detects infrared radiation emitted by the body, reflecting skin temperature influenced by blood flow, inflammation, and activity of the autonomic nervous system (ANS) (Zaproudina et al., 2006). Several studies have documented that OMT can induce varying thermal responses (warming, cooling, or thermal stability), reflecting sympathetic or parasympathetic changes depending on the technique used (Conquet, 2008; Rodrigues et al., 2020), the treated region, and the patient’s condition. In some cases, cooling has been observed after thoracic or cervical manipulations, interpreted as sympathetic excitation, while other techniques—such as craniosacral treatment—have induced facial warming, associated with parasympathetic activation (Chilton & Bhandare, 2025).

Practical Applications in Osteopathic Practice

IT enables osteopathic professionals to detect thermal asymmetries related to somatic dysfunctions, monitor treatment response (Biasi et al., 2024), and explore correlations with pain or mobility progression. Although current evidence is still limited and heterogeneous, its use as a complementary tool appears promising in scenarios such as:

• Assessing areas of thermal hypermobility or hypomobility
• Monitoring chronic musculoskeletal pain and its response to OMT sessions (Polidori et al., 2018)
• Tracking inflammatory processes or autonomic activity (especially via facial thermography)
• Supporting clinical reasoning in complex cases where symptoms do not clearly correlate with physical findings

Additionally, artificial intelligence-based tools can help automate the detection of thermally altered regions, improve analysis reliability, and facilitate documentation of the patient’s clinical progression over time.

Limitations, Reliability, and Interpretation

Despite its potential, the clinical application of IT requires careful consideration of certain limitations. While the technical reliability of the devices is high, clinical interpretation of thermograms presents challenges, such as interobserver variability and the influence of environmental or patient-related factors (e.g., room temperature, recent physical activity, medication use) (Uematsu et al., 1988). Its use as a standalone diagnostic tool or to select vertebral segments for treatment is not currently supported by evidence. Instead, its value lies in monitoring physiological processes and supporting therapeutic tracking.

Conclusion

Infrared thermography represents a valuable complementary tool for osteopaths, especially for objectively monitoring physiological changes following OMT. While it does not replace clinical judgment or manual examination, its ability to detect thermal asymmetries, visualize autonomic responses, and document therapeutic evolution adds meaningful value to daily practice. The combination of IT with technologies such as ThermoHuman, along with comprehensive clinical evaluation, paves the way toward a more data-driven, safe, and quantifiable osteopathy.

Summary

Thermography applied to osteopathy offers a non-invasive way to observe the patient’s physiological response following manual intervention. It can detect thermal changes linked to autonomic or inflammatory processes, support treatment monitoring, and enhance clinical reasoning. Through tools like ThermoHuman, the analysis becomes more reliable and reproducible, reinforcing its role as a useful—though not substitutive—complement to traditional clinical assessment.

Bibliography

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