The effects of high-velocity low-amplitude thrust manipulation and mobilisation techniques on pressure pain threshold in the lumbar spine

Thomson, Oliver P.; Haig, Lesley; Mansfield, Hazel

doi:10.1016/j.ijosm.2008.07.003

Cited by 34 publications

(28 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Five studies investigating the effect of lumbar SMT on PPT have found no significant change [21, 23–26]. Four of these measured PPT only immediately following SMT [21, 23–25], so it is possible they may have missed an effect that developed over time, as occurred in our study. The remaining study found a trend toward increasing PPT but this did not reach significance at 30 min [26].…”

Section: Discussionmentioning

confidence: 72%

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

et al. 2016

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 72%

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

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Articles [19,32,33] did not provide the number of subjects in each experimental group. The others (except [30]) showed a more even distribution than one could expect with a proper randomization procedure. We therefore assumed that the fact that authors did not discuss the randomization procedure, in most cases, reflected the fact that it had not occurred.…”

Section: Resultsmentioning

confidence: 99%

The effect of spinal manipulative therapy on experimentally induced pain: a systematic literature review

et al. 2012

View full text Add to dashboard Cite

BackgroundAlthough there is evidence that spinal manipulative therapy (SMT) can reduce pain, the mechanisms involved are not well established. There is a need to review the scientific literature to establish the evidence-base for the reduction of pain following SMT.ObjectivesTo determine if SMT can reduce experimentally induced pain, and if so, if the effect is i) only at the level of the treated spinal segment, ii) broader but in the same general region as SMT is performed, or iii) systemic.DesignA systematic critical literature review.MethodsA systematic search was performed for experimental studies on healthy volunteers and people without chronic syndromes, in which the immediate effect of SMT was tested. Articles selected were reviewed blindly by two authors. A summary quality score was calculated to indicate level of manuscript quality. Outcome was considered positive if the pain-reducing effect was statistically significant. Separate evidence tables were constructed with information relevant to each research question. Results were interpreted taking into account their manuscript quality.ResultsTwenty-two articles were included, describing 43 experiments, primarily on pain produced by pressure (n = 27) or temperature (n = 9). Their quality was generally moderate. A hypoalgesic effect was shown in 19/27 experiments on pressure pain, produced by pressure in 3/9 on pain produced by temperature and in 6/7 tests on pain induced by other measures. Second pain provoked by temperature seems to respond to SMT but not first pain. Most studies revealed a local or regional hypoalgesic effect whereas a systematic effect was unclear. Manipulation of a “restricted motion segment” (“manipulable lesion”) seemed not to be essential to analgesia. In relation to outcome, there was no discernible difference between studies with higher vs. lower quality scores.ConclusionsThese results indicate that SMT has a direct local/regional hypoalgesic effect on experimental pain for some types of stimuli. Further research is needed to determine i) if there is also a systemic effect, ii) the exact mechanisms by which SMT attenuates pain, and iii) whether this response is clinically significant.

show abstract

“…Of particular interest is the link between autonomic activity, dermatomal distributions and segmental dysfunction for therapies such as CTM and SMT. A number of authors have stated that the dorsal periaqueductal grey (dPAG) is a common link in the chain between afferent stimulation and efferent output including autonomic change (for example Schmid et al, 2008;Sterling et al, 2001;Thomson et al, 2009). The dPAG is a structure known to be implicated in homeostatic (autonomic) regulation and descending inhibition (for example Baldry et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

A theoretical framework for the role of fascia in manual therapy

Simmonds

Miller

Gemmell

2012

Journal of Bodywork and Movement Therapies

View full text Add to dashboard Cite

The effects of high-velocity low-amplitude thrust manipulation and mobilisation techniques on pressure pain threshold in the lumbar spine

Cited by 34 publications

References 62 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

The effect of spinal manipulative therapy on experimentally induced pain: a systematic literature review

A theoretical framework for the role of fascia in manual therapy

Contact Info

Product

Resources

About