Osteopathic treatment of head pain and nasal congestion in adult sinusitis

INTERVENTION: E02.190.599 The individuals participating in the study will be allocated in a balanced way in three different groups: intervention (osteopathic manipulative treatment), simulated (simulated osteopathic manipulative treatment) and control (no treatment). Experimental group: 22 volunteers will participate in four meetings ,once a week, with a maximum duration of 20 minutes for each meeting. Participants will be treated with a osteopathic manual treatment, that simultaneously stimulate the lymphatic system, the spleen, the liver and the nervous system. Simulation group: 22 volunteers will participate in four meetings (once per week) with a maximum duration of 20 minutes for each meeting. The patients in this group will receive a simulation of the treatment proposed to the experimental group, applied by another researcher. Control group: 22 volunteers will not receive treatment. Pacients will be oriented to follow the doctors prescription. CONDITION: chronic sinusitis ; J32 J00‐J99 PRIMARY OUTCOME: EVA: The visual analogue scale (VAS) is a 10cm line where the patient makes a mark, the starting point (= 0) is no pain and at the end (= 10) the highest pain you can imagine to be marked at the present moment.; ; PFNI: The PFNI of the brand Clement Clark International Limited, model IN‐CHECK ORAL ATM will be used. This device consists of a plastic cylinder 20 cm long, with a diameter ranging from 3 cm to 4 cm, having two ends: in one of them there are small holes through which the inspired air passes and at the other end a facial mask of In contact with the volunteer's face. Inside the cylinder, there is a diaphragm that moves according to the maximum flow of inspired air. The diaphragm stops moving at the moment the flow ceases, and then the measurement is made on a scale ranging from 30‐370 liters / minute, which is engraved on the surface of the cylinder. The technique used to measure the participant's nasal inspiratory flow, in a sitting position properly resting, with a device attached to the anterior region of the nose by a small mask attached to a plastic cylinder through which the air passes through the forced inspiration. There will be three consecutive shots with a 1 minute interval between them being the patient oriented to inhale only through the nose. Obtaining the result is immediate and similar to the already known as Peak Flow expiratory normally used in Pulmonology for pulmonary expiratory capacity research. INCLUSION CRITERIA: Volunteers with clinical diagnosis of sinusitis; Nasal congestion symptom and or face pain; Both genders; non smokers; Age between 18 and 55 years SECONDARY OUTCOME: SNOT‐22: Sino‐Nasal Outcome Test 22 is a validated, self‐filling questionnaire that measures the severity of symptoms and the quality of life of patients with nasal symptoms. SNOT‐22 is composed of 22 questions related to the symptoms of chronic rhinosinusitis. The values of each symptom will be graded between 0 (no problems) and 5 (worst possible symptom). The values indicated in each item will be summed and related to a scale ranging from 0 to 110. The SNOT‐22 questionnaire is presented in a wide and unique way, even if its range is greater than the affection in focus. The first twelve items cover the physical symptoms (1‐12) and the other items (13‐22) address the patient's health. In addition, this questionnaire will be subdivided into 4 scales plus 2 items. They are: rhinologic symptoms (items 1‐5, 7 and 8), ear and face (items 9‐12), sleep (13‐15) and psychological problems (17‐22). The items "cough" and "wake up tired" will be addressed separately as a single item.