Changes in Biochemical Markers of Pain Perception and Stress Response After Spinal Manipulation

Plaza-Manzano, Gustavo; Molina, Filomena; Lomas‐Vega, Rafael; Martínez‐Amat, Antonio; Achalandabaso‐Ochoa, Alexander; Hita‐Contreras, Fidel

doi:10.2519/jospt.2014.4996

Cited by 47 publications

(66 citation statements)

References 66 publications

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“…Salivary cortisol level increase after cervical manipulations was also reported in a randomised, controlled trial performed by Valera-Calero et al [26]. Similar results were reported by Plaza-Manzano et al However, they did not observe differences in pre-and post-treatment cortisol level [27]. Nonetheless, it should be noted that the authors used peripheral blood samples to measure the hormone levels while collecting them, which may be associated with additional stress in the patient.…”

Section: Discussionsupporting

confidence: 71%

Cortisol, testosterone, and pain levels among patients undergoing McKenzie therapy and suboccipital relaxation

Miecznikowski

Kiczmer

Cygan³

et al. 2020

Medical Research Journal

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Sedentary lifestyle and the development of consumer electronics, often associated with a faulty posture, are widespread factors contributing to cervical spine dysfunction (CSD). The purpose of our study is to compare two methods of physical therapy of CSD: suboccipital relaxation and the McKenzie method. Their effect on perceived pain level and life quality was assessed using VAS and NDI scores. Serum levels of biochemical stress indicators like testosterone and cortisol were also evaluated. Eighty-six adult patients were divided into two groups: Group A and Group B. Group A included 42 patients treated using the McKenzie method. Group B consisted of 44 patients who underwent suboccipital relaxation. The therapy in both groups included three treatment sessions over a six-week period. Testosterone and cortisol levels were assessed using the ELISA technique. Pain evaluation was performed using the Visual Analogue Scale (VAS). The disability level was evaluated with the Neck Disability Index (NDI). In both groups, a similar improvement in VAS and NDI scores was observed. A distinct cortisol level decrease in patients subjected to the suboccipital relaxation was noticed, while the McKenzie method did not affect cortisolaemia significantly. We did not notice any difference in testosterone levels between the two groups. Both treatment methods contributed towards clinical improvement in our patients, represented by the drop in VAS and NDI scores. We also observed a biochemical improvement: decreased cortisol level in the group treated with suboccipital relaxation. Due to the important role of testosterone and cortisol in the pathogenesis of chronic pain, our study should be the pilot experience on their use as markers in CSD.

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Section: Discussionsupporting

confidence: 71%

Cortisol, testosterone, and pain levels among patients undergoing McKenzie therapy and suboccipital relaxation

Miecznikowski

Kiczmer

Cygan³

et al. 2020

Medical Research Journal

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“…However, a single session of spinal mobilization or manipulation produces significant yet shortlived neurophysiological effects, typically lasting 5 min or less [17,18]. More recently, there is moderate emerging evidence supporting a modulation of biochemical mechanisms as well, suggesting that a mechanical stimuli provided by SM can trigger changes in analgesic and anti-inflammatory serum markers in asymptomatic individuals [9,19].…”

Section: Introductionmentioning

confidence: 99%

“…A recent study suggested that the mechanical stimulus produced during cervical manipulation seems to increase the serum concentration of neurotensin, oxytocin, and cortisol in asymptomatic subjects [19]. Oxytocin, neurotensin, and orexin A have antinociceptive effects while it has been well established that the endocrine-related steroid hormone cortisol serves a role in analgesia as it relates to stress response as well as immune parameters associated with the inflammatory process [9,[19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

The immediate effects of cervical spine manipulation on pain and biochemical markers in females with acute non-specific mechanical neck pain: a randomized clinical trial

Lohman

Pacheco

Gharibvand

et al. 2018

Journal of Manual & Manipulative Therapy

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Study Design: Randomized clinical trial with pre-test, post-test control group design. Objectives: To examine the immediate effects of cervical spinal manipulation (CSM) on serum concentration of biochemical markers (oxytocin, neurotensin, orexin A, and cortisol). Background: Several studies have found an association between spinal manipulation (SM) and pain perception. However, the mechanism by which SM modulates pain remains undefined. Methods: Twenty-eight female subjects with non-specific mechanical neck pain were randomly assigned to one of two interventions (CSM versus sham CSM). Blood samples were drawn before and immediately after the respective interventions. Oxytocin, neurotensin, orexin A, and cortisol were measured from the blood and serum using the Milliplex Map Magnetic Bead Panel Immunoassay on the Luminex 200 Platform. Results: In the CSM group, there were significant increases in pre-versus post-manipulation mean oxytocin (154.5 ± 60.1 vs. 185.1 ± 75.6, p = .012); neurotensin (116.0 ± 26.5 vs.136.4 ± 34.1, p <. 001); orexin A (52.2 ± 31.1 vs. 73.8 ± 38.8, p < .01) serum concentration; but no significant differences in mean cortisol (p = .052) serum concentration. In the sham group, there were no significant differences in any of the biomarkers (p > .05). Conclusion: The results of the current study suggest that the mechanical stimuli provided through a CSM may modify neuropeptide expression by immediately increasing the serum concentration of nociception-related biomarkers (oxytocin, neurotensin, orexin A, but not cortisol) in the blood of female subjects with non-specific mechanical neck pain.

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“…65 Consideration is also given to the utilization of thoracic manipulation to benefi cially alter pain perception via biochemical markers. 66 Other forms of nonthrust manipulation techniques can be implemented consisting of central or unilateral posterior to anterior mobilizations on either the spinous or transverse process respectively, as well as rib nonthrust manipulations to improve the overall mobility of the sternum and rib cage. Performing nonthrust manipulations in a variety of positions to assess which technique(s) demonstrates the greatest change in the patient's asterisk sign, and functional outcome measures can be important when treating using an impairment-based approach on the absence of strong literature.…”

Section: Thoracic Hypomobilitymentioning

confidence: 99%

Thoracic Spine Manual Therapy for Aging and Older Individuals

Masaracchio

Ojha

MacDonald

2015

Topics in Geriatric Rehabilitation

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With the advancement of medicine and technology, along with improvements in preventative medicine, the average age of the US population continues to rise. Research estimates that by the year 2050, there will be more than 65 million older adults living, with 19 million being older than 85 years. As the population ages, more individuals will seek out physical therapy services for spine-related pathologies. Little evidence is currently available on the safety and effectiveness of manual therapy interventions in older adults. The purpose of this review was to discuss the safety and effectiveness of manual therapy interventions targeted at the thoracic spine in older individuals.sents the highest prevalence rates among the 4 conditions identifi ed. 4 These conditions, in addition to other less common conditions such as ankylosing spondylosis, frequently contribute to thoracic pain or immobility in the older adult. In addition, the presence of osteoporosis paired with the potential increased rate of falls results in higher risks of compression fractures in the thoracic spine in older adults. 3 Although primary thoracic pain has been cited as occurring less frequently than neck or low back pain, 5 it can be equally and/or more severe and disabling. 6 , 7 The point prevalence for thoracic spine pain ranges from 3% to 70%, with a 1-month prevalence that ranges from 10% to 38%, a 3-month prevalence between 13% and 39%, and a 1-year prevalence ranging from 25% to 55%. 8 In addition, there is research to suggest that thoracic spine pain increases during the middle adult years (40-50 years), with a decrease in later adult years ( > 70 years). 9 Furthermore, because of the proximity of the thoracic spine to the cervical, lumbar, and shoulder regions, dysfunction in the thoracic spine and/or rib cage can potentially have an infl uence on pain, mobility, and stability in these regions. While mechanisms are unclear, substantial evidence suggests that manual therapy interventions directed at the thoracic spine can decrease pain and improve motion in the thoracic spine and adjacent regions. 10-20 According to the Guide to Physical Therapy Practice, 21 manual therapy can be defi ned as techniques that involve skilled passive movements to the joints and/or related soft tissues that can be applied at varying speeds and amplitudes, including a small-amplitude, high-velocity movement (thrust manipulation). 10 Considering the central role the thoracic spine has in spinal health, the aging population, and the relative cost-effectiveness of manual therapy for managing spinal pain, 22 the main aims of this article are to review thoracic spine anatomy, biomechanics, pathoanatomy, and differential diagnosis to establish the current knowledge of the role of manual therapy and exercise as interventions in the management of thoracic spinal pain in older individuals. THORACIC SPINE ANATOMY AND MECHANICSThe thoracic spine is conceptually divided into 3 regions: an upper (T1-T3), a middle (T4-T7), and a lower (T8-T12) thoracic spine. 23 In addition...

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Changes in Biochemical Markers of Pain Perception and Stress Response After Spinal Manipulation

Cited by 47 publications

References 66 publications

Cortisol, testosterone, and pain levels among patients undergoing McKenzie therapy and suboccipital relaxation

Cortisol, testosterone, and pain levels among patients undergoing McKenzie therapy and suboccipital relaxation

The immediate effects of cervical spine manipulation on pain and biochemical markers in females with acute non-specific mechanical neck pain: a randomized clinical trial

Thoracic Spine Manual Therapy for Aging and Older Individuals

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