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Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study

BACKGROUND: The underlying causes of spinal manipulation hypoalgesia are largely unknown. The beneficial clinical effects were originally theorized to be due to biomechanical changes, but recent research has suggested spinal manipulation may have a direct neurophysiological effect on pain perception...

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Autores principales: George, Steven Z, Bishop, Mark D, Bialosky, Joel E, Zeppieri, Giorgio, Robinson, Michael E
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1578563/
https://www.ncbi.nlm.nih.gov/pubmed/16911795
http://dx.doi.org/10.1186/1471-2474-7-68
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author George, Steven Z
Bishop, Mark D
Bialosky, Joel E
Zeppieri, Giorgio
Robinson, Michael E
author_facet George, Steven Z
Bishop, Mark D
Bialosky, Joel E
Zeppieri, Giorgio
Robinson, Michael E
author_sort George, Steven Z
collection PubMed
description BACKGROUND: The underlying causes of spinal manipulation hypoalgesia are largely unknown. The beneficial clinical effects were originally theorized to be due to biomechanical changes, but recent research has suggested spinal manipulation may have a direct neurophysiological effect on pain perception through dorsal horn inhibition. This study added to this literature by investigating whether spinal manipulation hypoalgesia was: a) local to anatomical areas innervated by the lumbar spine; b) correlated with psychological variables; c) greater than hypoalgesia from physical activity; and d) different for A-delta and C-fiber mediated pain perception. METHODS: Asymptomatic subjects (n = 60) completed baseline psychological questionnaires and underwent thermal quantitative sensory testing for A-delta and C-fiber mediated pain perception. Subjects were then randomized to ride a stationary bicycle, perform lumbar extension exercise, or receive spinal manipulation. Quantitative sensory testing was repeated 5 minutes after the intervention period. Data were analyzed with repeated measures ANOVA and post-hoc testing was performed with Bonferroni correction, as appropriate. RESULTS: Subjects in the three intervention groups did not differ on baseline characteristics. Hypoalgesia from spinal manipulation was observed in lumbar innervated areas, but not control (cervical innervated) areas. Hypoalgesic response was not strongly correlated with psychological variables. Spinal manipulation hypoalgesia for A-delta fiber mediated pain perception did not differ from stationary bicycle and lumbar extension (p > 0.05). Spinal manipulation hypoalgesia for C-fiber mediated pain perception was greater than stationary bicycle riding (p = 0.040), but not for lumbar extension (p = 0.105). CONCLUSION: Local dorsal horn mediated inhibition of C-fiber input is a potential hypoalgesic mechanism of spinal manipulation for asymptomatic subjects, but further study is required to replicate this finding in subjects with low back pain.
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spelling pubmed-15785632006-09-27 Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study George, Steven Z Bishop, Mark D Bialosky, Joel E Zeppieri, Giorgio Robinson, Michael E BMC Musculoskelet Disord Research Article BACKGROUND: The underlying causes of spinal manipulation hypoalgesia are largely unknown. The beneficial clinical effects were originally theorized to be due to biomechanical changes, but recent research has suggested spinal manipulation may have a direct neurophysiological effect on pain perception through dorsal horn inhibition. This study added to this literature by investigating whether spinal manipulation hypoalgesia was: a) local to anatomical areas innervated by the lumbar spine; b) correlated with psychological variables; c) greater than hypoalgesia from physical activity; and d) different for A-delta and C-fiber mediated pain perception. METHODS: Asymptomatic subjects (n = 60) completed baseline psychological questionnaires and underwent thermal quantitative sensory testing for A-delta and C-fiber mediated pain perception. Subjects were then randomized to ride a stationary bicycle, perform lumbar extension exercise, or receive spinal manipulation. Quantitative sensory testing was repeated 5 minutes after the intervention period. Data were analyzed with repeated measures ANOVA and post-hoc testing was performed with Bonferroni correction, as appropriate. RESULTS: Subjects in the three intervention groups did not differ on baseline characteristics. Hypoalgesia from spinal manipulation was observed in lumbar innervated areas, but not control (cervical innervated) areas. Hypoalgesic response was not strongly correlated with psychological variables. Spinal manipulation hypoalgesia for A-delta fiber mediated pain perception did not differ from stationary bicycle and lumbar extension (p > 0.05). Spinal manipulation hypoalgesia for C-fiber mediated pain perception was greater than stationary bicycle riding (p = 0.040), but not for lumbar extension (p = 0.105). CONCLUSION: Local dorsal horn mediated inhibition of C-fiber input is a potential hypoalgesic mechanism of spinal manipulation for asymptomatic subjects, but further study is required to replicate this finding in subjects with low back pain. BioMed Central 2006-08-15 /pmc/articles/PMC1578563/ /pubmed/16911795 http://dx.doi.org/10.1186/1471-2474-7-68 Text en Copyright © 2006 George et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
George, Steven Z
Bishop, Mark D
Bialosky, Joel E
Zeppieri, Giorgio
Robinson, Michael E
Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study
title Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study
title_full Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study
title_fullStr Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study
title_full_unstemmed Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study
title_short Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study
title_sort immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1578563/
https://www.ncbi.nlm.nih.gov/pubmed/16911795
http://dx.doi.org/10.1186/1471-2474-7-68
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