Immediate effects from manual therapy: much ado about nothing?

Cook, Chad

doi:10.1179/106698110x12804993427009

Cited by 30 publications

(14 citation statements)

References 28 publications

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“…A methodological weakness of these studies is the failure to link the observed findings to clinical outcomes. 17 The clinical findings of the current study allow for interpretation of the clinical relevance of SMT related changes in pain sensitivity.…”

Section: Discussionmentioning

confidence: 77%

Spinal Manipulative Therapy–Specific Changes in Pain Sensitivity in Individuals With Low Back Pain (NCT01168999)

Bialosky

George

Horn

et al. 2014

The Journal of Pain

107

156

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Spinal Manipulative Therapy (SMT) is effective for some individuals experiencing low back pain (LBP); however, the mechanisms are not established regarding the role of placebo. SMT is associated with changes in pain sensitivity suggesting related altered central nervous system response or processing of afferent nociceptive input. Placebo is also associated with changes in pain sensitivity and the efficacy of SMT for changes in pain sensitivity beyond placebo has not been adequately considered. We randomly assigned 110 participants with LBP to receive SMT, placebo SMT, placebo SMT with the instructional set, “The manual therapy technique you will receive has been shown to significantly reduce low back pain in some people”, or no intervention. Participants receiving the SMT and placebo SMT received their assigned intervention 6 times over two weeks. Pain sensitivity was assessed prior to and immediately following the assigned intervention during the first session. Clinical outcomes were assessed at baseline and following two weeks of participation in the study. Immediate attenuation of suprathreshold heat response was greatest following SMT (p= 0.05, partial η2= 0.07). Group dependent differences were not observed for changes in pain intensity and disability at two week. Participant satisfaction was greatest following the enhanced placebo SMT.

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Section: Discussionmentioning

confidence: 77%

Spinal Manipulative Therapy–Specific Changes in Pain Sensitivity in Individuals With Low Back Pain (NCT01168999)

Bialosky

George

Horn

et al. 2014

The Journal of Pain

107

156

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“…Collectively, these studies provide evidence that SMT has an immediate effect on reducing pain sensitivity, most notably at the remote region of stimulus assessment with similar results in clinical and healthy populations. Although this an important first step, Cook [Cook, 2011] has highlighted the need for examining the effect of SMT beyond an immediate follow-up since 1.) many interventions (including those considered ineffective) demonstrate a favorable immediate effect, and 2.)…”

Section: Discussionmentioning

confidence: 99%

Changes in pain sensitivity following spinal manipulation: A systematic review and meta-analysis

Coronado¹,

Gay²,

Bialosky³

et al. 2012

Journal of Electromyography and Kinesiology

167

138

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Spinal manipulation (SMT) is commonly used for treating individuals experiencing musculoskeletal pain. The mechanisms of SMT remain unclear; however, pain sensitivity testing may provide insight into these mechanisms. The purpose of this systematic review is to examine the literature on the hypoalgesic effects of SMT on pain sensitivity measures and to quantify these effects using meta-analysis. We performed a systematic search of articles using CINAHL, MEDLINE, PsycINFO, and SPORTDiscus from each databases’ inception until May 2011. We examined methodological quality of each study and generated pooled effect size estimates using meta-analysis software. Of 997 articles identified, 20 met inclusion criteria for this review. Pain sensitivity testing used in these studies included chemical, electrical, mechanical, and thermal stimuli applied to various anatomical locations. Meta-analysis was appropriate for studies examining the immediate effect of SMT on mechanical pressure pain threshold (PPT). SMT demonstrated a favorable effect over other interventions on increasing PPT. Subgroup analysis showed a significant effect of SMT on increasing PPT at the remote sites of stimulus application supporting a potential central nervous system mechanism. Future studies of SMT related hypoalgesia should include multiple experimental stimuli and test at multiple anatomical sites.

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“…Second, the findings must be cautiously interpreted because the study has only assessed immediate effects. Long-term results should be evaluated in future studies [53]. Finally, the measurement of catecholamines and serotonin plasma level is complex because it is influenced by food intake, stress, and patient position, and it shows a circadian rhythm [54].…”

Section: Limitationsmentioning

confidence: 99%

Changes in Pain Perception after Pelvis Manipulation in Women with Primary Dysmenorrhea: A Randomized Controlled Trial

et al. 2014

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Immediate effects from manual therapy: much ado about nothing?

Cited by 30 publications

References 28 publications

Spinal Manipulative Therapy–Specific Changes in Pain Sensitivity in Individuals With Low Back Pain (NCT01168999)

Spinal Manipulative Therapy–Specific Changes in Pain Sensitivity in Individuals With Low Back Pain (NCT01168999)

Changes in pain sensitivity following spinal manipulation: A systematic review and meta-analysis

Changes in Pain Perception after Pelvis Manipulation in Women with Primary Dysmenorrhea: A Randomized Controlled Trial

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