The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia

Abstract

Manipulative therapy is frequently used in the management of musculoskeletal pain. A frequently reported clinical feature of this treatment is the immediacy with which it appears to initiate improvement in pain and function. A randomised, double blind, placebo controlled, repeated measures design was employed to study the initial effects of a cervical spine treatment technique in a group of 15 patients with lateral epicondylalgia. Pressure pain threshold, pain-free grip strength, upper limb neurodynamics, pain and function were assessed prior to and following application of either a treatment, placebo or control condition. All subjects received all three conditions. Differences between the pre-post measures were used as indicators of change in subject's symptom profiles. The treatment condition produced significant improvement in pressure pain threshold, pain-free grip strength, neurodynamics and pain scores relative to placebo and control conditions (P < 0.05). In summary, this study demonstrates that manipulative therapy is capable of eliciting a rapid hypoalgesic effect.

The immediate effects of soft tissue mobilization versus therapeutic ultrasound for patients with neck and arm pain with evidence of neural mechanosensitivity: a randomized clinical trial

“…9,11,15,[19][20][21][22][23] An example of such an intervention includes the cervical lateral glide mobilization with the involved upper extremity placed in a position designed to take up the slack in the brachial plexus. 16,21,24,25 However, several authors have advised against applying cervical spine mobilization techniques to patients who demonstrate either normal or excessive mobility of the cervical spine, 26,27 which may include some patients with cervicobrachial syndrome. 17 Hypermobility is a frequent finding in patients with whiplash-associated disorder, 28 a group who commonly reports neck and arm pain.…”

Immediate Effects of Counterforce Forearm Brace on Grip Strength and Wrist Extension Force in Patients with Lateral Epicondylosis

“…It is tempting to speculate the mechanism of action by which the counterforce forearm brace achieved its effects in improving grip strength. One possible explanation is that a direct mechanical effect on the muscles of the forearm somehow improved the internal (SnyderMackler & Epler, 1989;Vicenzino, Collins, & Wright, 1996). The theory of the mechanical effect on muscle is similar to that postulated, but not proven, for other orthotic braces for this condition (Snyder-Mackler & Epler;Vicenzino, Brooksband, Minto, Offord, & Paungmali, 2003).…”

Effects of the Inclusion Thoracic Mobilization into Cranio-Cervical Flexor Exercise in Patients with Chronic Neck Pain

“…Therefore, although this study did not identify the range of joint motions, we think that the recovery of mobility achieved by thoracic mobilizations affected all the measured parameters. Earlier studies [17][18][19] indicated that manual therapy interventions to the spine were effective in alleviating pain occurring in areas distal to the area being directly treated. It has also been reported that the reason why manual therapy conducted on the spine shows alleviation of pain is that it stimulates inhibition mechanisms 20) .…”