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Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial

Background. Manual therapy (MT) is a treatment recommended by clinical practice guidelines in the management of patients with neck pain. However, the mechanisms through which MT works remain unknown. The aim of the present study is to investigate if MT is mediated by mechanisms related to conditione...

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Autores principales: Arribas-Romano, Alberto, Fernández-Carnero, Josué, González-Zamorano, Yeray, Rodríguez-Lagos, Leonardo, Alguacil-Diego, Isabel María, Molina-Álvarez, Miguel, Tejera, David Morales, Mercado-Romero, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298868/
https://www.ncbi.nlm.nih.gov/pubmed/37373589
http://dx.doi.org/10.3390/jcm12123894
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author Arribas-Romano, Alberto
Fernández-Carnero, Josué
González-Zamorano, Yeray
Rodríguez-Lagos, Leonardo
Alguacil-Diego, Isabel María
Molina-Álvarez, Miguel
Tejera, David Morales
Mercado-Romero, Francisco
author_facet Arribas-Romano, Alberto
Fernández-Carnero, Josué
González-Zamorano, Yeray
Rodríguez-Lagos, Leonardo
Alguacil-Diego, Isabel María
Molina-Álvarez, Miguel
Tejera, David Morales
Mercado-Romero, Francisco
author_sort Arribas-Romano, Alberto
collection PubMed
description Background. Manual therapy (MT) is a treatment recommended by clinical practice guidelines in the management of patients with neck pain. However, the mechanisms through which MT works remain unknown. The aim of the present study is to investigate if MT is mediated by mechanisms related to conditioned pain modulation (CPM), comparing the effects of painful with a pain-free MT treatment. Methods. A two-arm, parallel, randomized controlled clinical trial with concealed allocation and blinding of the outcome assessor was conducted in university students with chronic or recurrent nonspecific neck pain (NSNP). Participants received either a painful or pain-free MT session. Psychophysical variables including pressure pain thresholds, CPM, temporal summation of pain and cold pain intensity were assessed before and immediately after treatment. In addition, changes in neck pain intensity over the following 7 days and self-perceived improvement immediately and 7 days after treatment were assessed. Results: No significant differences were found between groups in any of the psychophysical variables or in patients’ self-perceived improvement. Only a significantly greater decrease in neck pain intensity immediately after treatment was found in the pain-free MT group compared to the painful MT group. Conclusion: The results suggest that the immediate and short-term effects of MT on NSNP are not mediated by CPM-related mechanisms.
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spelling pubmed-102988682023-06-28 Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial Arribas-Romano, Alberto Fernández-Carnero, Josué González-Zamorano, Yeray Rodríguez-Lagos, Leonardo Alguacil-Diego, Isabel María Molina-Álvarez, Miguel Tejera, David Morales Mercado-Romero, Francisco J Clin Med Article Background. Manual therapy (MT) is a treatment recommended by clinical practice guidelines in the management of patients with neck pain. However, the mechanisms through which MT works remain unknown. The aim of the present study is to investigate if MT is mediated by mechanisms related to conditioned pain modulation (CPM), comparing the effects of painful with a pain-free MT treatment. Methods. A two-arm, parallel, randomized controlled clinical trial with concealed allocation and blinding of the outcome assessor was conducted in university students with chronic or recurrent nonspecific neck pain (NSNP). Participants received either a painful or pain-free MT session. Psychophysical variables including pressure pain thresholds, CPM, temporal summation of pain and cold pain intensity were assessed before and immediately after treatment. In addition, changes in neck pain intensity over the following 7 days and self-perceived improvement immediately and 7 days after treatment were assessed. Results: No significant differences were found between groups in any of the psychophysical variables or in patients’ self-perceived improvement. Only a significantly greater decrease in neck pain intensity immediately after treatment was found in the pain-free MT group compared to the painful MT group. Conclusion: The results suggest that the immediate and short-term effects of MT on NSNP are not mediated by CPM-related mechanisms. MDPI 2023-06-07 /pmc/articles/PMC10298868/ /pubmed/37373589 http://dx.doi.org/10.3390/jcm12123894 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Arribas-Romano, Alberto
Fernández-Carnero, Josué
González-Zamorano, Yeray
Rodríguez-Lagos, Leonardo
Alguacil-Diego, Isabel María
Molina-Álvarez, Miguel
Tejera, David Morales
Mercado-Romero, Francisco
Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial
title Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial
title_full Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial
title_fullStr Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial
title_full_unstemmed Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial
title_short Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial
title_sort manual therapy effects on nonspecific neck pain are not mediated by mechanisms related to conditioned pain modulation: a randomized clinical trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10298868/
https://www.ncbi.nlm.nih.gov/pubmed/37373589
http://dx.doi.org/10.3390/jcm12123894
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