Using a specialized infrared thermographic camera, I measure skin temperature during my evaluations. I am often concerned about unusual or persistent temperature changes, and I am finding it useful for evaluation and treatment guidance.
Fibrotic tissue: What got me into thermal imaging was my interest in the fascia, especially dysfunctional collagen healing and the fascia system. Excessive deposition of fibrous connective tissue (collagen) is typically cooler to the touch than normal surrounding tissue. This difference in temperature is often due to reduced blood flow in the fibrotic area: Fibrosis can impair blood circulation, leading to less warmth and a cooler sensation when compared to healthy tissue with good blood flow. Using thermal imaging to detect temperature difference is easily discernible, and having a simple-to-use, hand-held system helps me expand on the extent and location of fibrotic tissue in real-time.
Generally, skin temperature is lower than the body’s core temperature. A typical range for skin temperature at various body locations is as follows:
- Forehead: Approximately 33-35°C (91-95°F)
- Chest and back: Around 32-34°C (90-93°F)
- Arm and leg: About 30-32°C (86-90°F)
- Hands and feet: Usually lower, around 28-30°C (82-86°F)
Keep in mind, these are approximate values, and the average skin temperature of a human being can vary and change depending on several factors, including the location of measurement, environmental (ambient temperature), individual physiology, activity level, circulation and blood flow, insulation, metabolic activity, emotions and other factors.
The skin acts as a barrier between the body’s internal tissues and the external environment, so the relationship between skin temperature and underlying tissue temperature is not straightforward.
Thermography measures the infrared radiation emitted by the skin’s surface, which is affected by the temperature of the blood vessels near the skin’s surface, as well as the skin’s ability to dissipate heat. The temperature of the underlying tissue, however, can differ from the surface temperature. There’s no universally fixed conversion between skin temperature measured by thermal imaging and the exact temperature of the underlying tissue. However, it’s generally understood that the deeper you go beneath the skin’s surface, the cooler the tissues tend to be. For instance, subcutaneous fat, muscle and organs generally have lower temperatures than the skin’s surface. I am looking for asymmetrical areas, cooler spots or warmer spots within a quarter (upper or lower quarter) of the body.
Temperature changes
Increases and decreases in skin temperature can each act as indicators of a variety of physiological processes. The following discussion provides a general overview of how they can impact the body and how you can use this information.
Increased skin temperature
Vasodilation: When skin temperature increases, blood vessels near the surface of the skin dilate (widen). This is part of the body’s natural cooling mechanism. Increased blood flow to the skin allows excess heat to be released into the surrounding environment. Within a treatment session, I can decide if I want to create increased blood flow or decrease the surrounding blood flow.
Inflammation and infection: Elevated skin temperature can sometimes be a sign of inflammation or infection. Inflammatory responses can cause localized heating due to increased blood flow and immune system activity.
Exercise and physical activity: Engaging in physical activities can lead to increased skin temperature due to increased metabolic activity and blood flow to working muscles. When the images I take after movement therapy reveal cooler spots within fascial layers, I know I may be dealing with dense fascial chains and decide to use scraping tools or other modalities to increase the blood flow, which I can then verify via thermographic detection of the skin temperature.
Fever: Elevated body temperature, including skin temperature, can be a symptom of fever. Fever is often a response to infections and other medical conditions as the body’s immune system ramps up its defenses.
Thermoregulation disorders: Conditions like hyperthyroidism can lead to increased metabolic rate, which can raise both body and skin temperatures. Seeing real-time asymmetrical temperature differences in one foot or hand versus the other has been helpful in diagnosis and monitoring the results of therapy.
Decreased skin temperature
Vasoconstriction: When skin temperature drops, blood vessels near the skin’s surface constrict (narrow). This helps conserve heat in the body by reducing blood flow to the skin. Reduced blood flow often has a cause-and-effect relationship between healthy and non-healthy gliding fascia. This shows up in the images as a localized part or a wider anatomical range.
Cold exposure: Exposing the body to cold temperatures leads to lowered skin temperature. The body responds by constricting blood vessels and initiating shivering to generate heat. Visually seeing the temperature gauge with a thermal image creates patient engagement for at-home therapy compliance.
Hypothermia: Prolonged exposure to cold can lead to hypothermia, a dangerous condition where the body’s core temperature drops to a level that impairs normal physiological functions.
Poor circulation: Reduced blood flow due to vasoconstriction can lead to lowered skin temperature. Conditions like Raynaud’s disease can cause extreme sensitivity to cold and result in skin discoloration and discomfort. Allowing patients to visually see the image of cooler spots is as valuable as seeing hot spots. I have integrated these images into patients’ guided meditation and breathing moments to help promote relaxation and increase blood flow to enhance poor circulation as part of self-healing.
Anxiety and stress: In some cases, anxiety or stress can lead to vasoconstriction and a sensation of coldness in the extremities.
In both cases, skin temperature changes are often part of the body’s intricate regulatory mechanisms to maintain homeostasis. These responses are influenced by factors, such as the autonomic nervous system, hormones and local tissue conditions. Thermography provides valuable insight into these internal processes by monitoring temperature changes in the skin.
Final thoughts
Chiropractic has become so much more to me than neuron disruption. DCs were among the first wholistic health practitioners now trending as “biohacking.” Chiropractic embodies lifestyle choices, and we are interested in vessel health, lymph flow, breath work, frequency (sound therapy), tone, light therapy and temperature. Determining overall cognitive health, mental health and physical health before it becomes a symptom or changes behavior requires a wholistic approach.
I’ve strived to help people before they get ill or help people be at the top of their game for as long as possible. I think medical thermography is ready for the masses and will help practitioners diagnose temperature changes related to acute and unresolving pain.
JEFFREY TUCKER, DC, DACRB, is in private practice in Los Angeles, Calif. Visit his website, DrJeffreyTucker.com, for more information about his practice.
