Immediate effects of spinal manipulation on nitric oxide, substance P and pain perception

Molina, Filomena; Lomas‐Vega, Rafael; Hita‐Contreras, Fidel; Plaza-Manzano, Gustavo; Ramos-Morcillo, Antonio Jesús; Martínez‐Amat, Antonio

doi:10.1016/j.math.2014.02.007

Cited by 44 publications

(31 citation statements)

References 57 publications

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“…The results of studies in the lumbar spine are in stark contrast to cervical spine literature, which quite consistently demonstrate increases in PPT [16, 19, 28–31, 46, 49], and are in agreement with our own study of the lumbar spine. Additionally, other studies have demonstrated mechanical hypoalgesia following lumbar mobilisation [50, 51], lending further strength to our findings.…”

Section: Discussionsupporting

confidence: 90%

“…Two recent systematic reviews concluded that SMT has an overall effect of increasing PPT (reducing sensitivity) at sites local to the SMT and remotely [13, 14]. The remote effect may be regional [15, 16] (at a peripheral site innervated by the target spinal region) or systemic [17–20]. SMT also appears to reduce sensitivity to other types of experimental pain [13, 14].…”

Section: Introductionmentioning

confidence: 99%

“…The duration of change to pain sensitivity following SMT is also unknown as, in the few studies that have collected data beyond 10 min, findings are mixed [15, 16, 27, 28]. Reductions in pain sensitivity appear to be bilateral [29–33], but there may be asymmetry related to dominant side [31, 32] or side of SMT [29, 30, 33].…”

Section: Introductionmentioning

confidence: 99%

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Effect of lumbar spinal manipulation on local and remote pressure pain threshold and pinprick sensitivity in asymptomatic individuals: a randomised trial

et al. 2016

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BackgroundThe mechanisms of clinical pain relief associated with spinal manipulative therapy (SMT) are poorly understood. Our objective was to determine whether lumbar high-velocity low-amplitude SMT altered pressure pain threshold (PPT) and pinprick sensitivity (PPS) locally and remotely, how long any change lasted (up to 30 min), and whether changes related to the side of SMT.MethodsThirty-four asymptomatic participants (mean age 22.6 years ±4.0) received a right- or left-sided lumbar SMT. PPT and PPS were measured bilaterally at the calf, lumbar spine, scapula, and forehead before and immediately, 10, 20, and 30 min after intervention. Data were collected between October 2014 and June 2015.ResultsBilateral calf and lumbar spine PPT increased significantly after 10 – 20 min and was maintained at 30 min (7.2–11.8 % increase). PPS decreased significantly in all locations at various times (9.8 – 22.5 % decrease). At the calf and lumbar spine, PPT increased slightly more ipsilateral to the SMT than contralateral.ConclusionsLumbar SMT reduced deep pressure sensitivity locally and in the lower limbs for at least 30 min, whereas sensitivity to pinprick was reduced systemically. These findings suggest that SMT specifically inhibits deep pressure sensitivity distally. These findings are novel compared to other lumbar SMT studies, and may reflect a local spinal or complex supraspinal analgesic mechanism.Trial registrationRegistered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000682640).Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-016-0128-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Effect of lumbar spinal manipulation on local and remote pressure pain threshold and pinprick sensitivity in asymptomatic individuals: a randomised trial

et al. 2016

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“…In agreement with our findings, another study with HVLA spinal manipulation showed no alteration in plasma levels of NO in healthy subjects, either immediately or 2 hours after the intervention. 72 The same authors found only a correlation with the pain sensitivity at the pressure-pain threshold. These authors suggested that NO can be involved in pain sensitization but may not be a key element in the analgesic effects of spinal manipulation.…”

Section: Discussionmentioning

confidence: 96%

Peripheral Oxidative Stress Blood Markers in Patients With Chronic Back or Neck Pain Treated With High-Velocity, Low-Amplitude Manipulation

Kolberg

Horst

Moraes

et al. 2015

Journal of Manipulative and Physiological Therapeutics

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“…Wright (1995) demonstrated the effect of manipulation on this system by noting the specific responses of dPAG activation, most markedly being rapid analgesia. An increase in substance P, which has a potent analgesic effect, has also been shown to occur with joint manipulation (Molina-Ortega et al, 2014).…”

Section: 4mentioning

confidence: 99%

The effect of lumbosacral manipulation on growing pains

Beer

Bester

2015

Health SA Gesondheid

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a b s t r a c tBackground: Growing pains are a frequent clinical presentation that continues to puzzle practitioners, with very little conclusive evidence in any medical field, including chiropractic.Objective: The aim of this study was to determine whether lumbosacral manipulations have an effect on growing pain symptoms.Methods: Thirty participants with growing pains between the ages of 4 and 12 years were recruited. The participants were placed into two groups of 15 participants each. Group 1 received lumbosacral manipulations to restricted joints as determined by motion palpation, while Group 2 never received any professional intervention. Often parent(s)/guardian(s) of children who suffer from growing pains will rub the child's legs and offer verbal reassurance in an attempt to console their children. Parent(s)/guardian(s) of both groups were encouraged to continue to do this throughout the duration of the trial. Instructions were given to the parents so that the same rubbing technique and rubbing cream (aqueous cream) were used. Subjective changes were tracked using a pain diary that the parent(s)/ guardian(s) were asked to complete, a six-week post-study follow-up question regarding children's growing pains and the Oucher self-report pain scale. Objective measures consisted of pressure algometer readings of the tibialis anterior muscle belly.Results: The statistical data was analysed using the Friedman test, ManneWhitney test and the Wilcoxon Signed-Rank test. The results demonstrated that both groups responded favourably to their specific treatment over time. However, the group that received lumbosacral manipulations proved to show a quicker response to treatment; and the poststudy follow-up of this same group showed markedly more positive feedback than the group that did not receive the treatment. These results highlighted the positive effects of chiropractic manipulation on growing pain symptoms. Conclusion:The results from this study, specifically the feedback from parent(s)/guardians(s) and the pain diaries, indicated that spinal manipulation is beneficial in the treatment of growing pains. The results also showed that other methods of treating growing pains, such as simple leg rubs, may also bring relief. Peer review under responsibility of Johannesburg University. H O S T E D BYh e a l t h s a g e s o n d h e i d 2 0 ( 2 0 1 5 ) 7 5 e8 2http://dx

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Immediate effects of spinal manipulation on nitric oxide, substance P and pain perception

Cited by 44 publications

References 57 publications

Effect of lumbar spinal manipulation on local and remote pressure pain threshold and pinprick sensitivity in asymptomatic individuals: a randomised trial

Effect of lumbar spinal manipulation on local and remote pressure pain threshold and pinprick sensitivity in asymptomatic individuals: a randomised trial

Peripheral Oxidative Stress Blood Markers in Patients With Chronic Back or Neck Pain Treated With High-Velocity, Low-Amplitude Manipulation

The effect of lumbosacral manipulation on growing pains

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