Counterirritation: yesterday, today, tomorrow

Background. Counterirritation is a physical therapy technique that has been used for centuries to relieve pain and inflammation. It involves creating an artificial irritation on the skin to alleviate the irritation or inflammation of deeper structures. The purpose – of this study is to analyze the use of counterirritants in medical practice during the XIX and XXI centuries. The study utilized XIX century physical therapy treatises and XX–XXI century counterirritants research. Materials and Methods. The search for sources was carried out in the databases Scopus Web of Science, PubMed, MEDlars onLINE, Crossref, and Google Scholar, as well as in the libraries and repositories of medical universities. The study used the following methodology: analysis and synthesis methods, historical, source, comparative, and generalizing, ways of studying physical therapy techniques based on the counterirritation principle. Results. In ancient times until the mid-XIX century, medical practitioners did not fully understand the mechanisms of action of counterirritants. Therefore, therapy with counterirritants was based solely on empirical observations. Despite being painful, such physical therapy was widespread in Europe because there were no better alternatives. In the second half of the XIX century, the study of counterirritation mechanisms received a scientific basis, and the important role of reflex influence mediated through the corresponding segments of the spinal cord was established. In the XX century, counterirritation methods improved with increased requirements for the safety and effectiveness of treatment. In the XXI century, the application of counterirritation in healthcare expanded beyond the scope of analgesic and antiinflammatory effects. The emergence of new technical means using sound and light stimuli illuminates novel ways for the development of the counter-irritation method over time. Various traditional practices like massage, cupping, patches, heating, and cauterization, which have been reliable since the XIX century, have now largely been replaced by kinesiotherapy and neurostimulation. Recent research has uncovered unknown effects of peripheral neurostimulation that require further investigation. Conclusions. Despite numerous studies, the mechanisms of the analgesic and anti-inflammatory effects of counterirritants are still not fully understood. This means that their therapeutic possibilities are far from exhausted.