Pain-Relieving Effects of Cervical Manual Therapy

Wright, Anthony

doi:10.1016/b978-0-443-06564-4.50015-3

Cited by 13 publications

(4 citation statements)

References 58 publications

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“…The increases in PPT levels over both masseter and temporalis muscles suggests that a hypoalgesic effects may be induced by treatment of the cervical spine. Previous evidence suggests that the hypoalgesic effects occur after manual therapy interventions because of the activation of the descending inhibitory pathways (45, 46). It has been demonstrated that joint mobilization of the cervical spine produced an increase of 25% in PPTs in patients with lateral epicondylalgia (47) and in patients with neck pain (48).…”

Section: Discussionmentioning

confidence: 99%

The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders

Touche

Fernández‐de‐las‐Peñas

Fernández‐Carnero

et al. 2009

J of Oral Rehabilitation

128

113

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No studies have investigated the effects of the treatments directed at the cervical spine in patients with temporomandibular disorders (TMD). Our aim was to investigate the effects of joint mobilization and exercise directed at the cervical spine on pain intensity and pressure pain sensitivity in the muscles of mastication in patients with TMD. Nineteen patients (14 females), aged 19-57 years, with myofascial TMD were included. All patients received a total of 10 treatment session over a 5-week period (twice per week). Treatment included manual therapy techniques and exercise directed at the cervical spine. Outcome measures included bilateral pressure pain threshold (PPT) levels over the masseter and temporalis muscles, active pain-free mouth opening (mm) and pain (Visual Analogue Scale) and were all assessed pre-intervention, 48 h after the last treatment (post-intervention) and at 12-week follow-up period. Mixed-model anovas were used to examine the effects of the intervention on each outcome measure. Within-group effect sizes were calculated in order to assess clinical effect. The 2 x 3 mixed model anova revealed significant effect for time (F = 77.8; P < 0.001) but not for side (F = 0.2; P = 0.7) for changes in PPT over the masseter muscle and over the temporalis muscle (time: F = 66.8; P < 0.001; side: F = 0.07; P = 0.8). Post hoc revealed significant differences between pre-intervention and both post-intervention and follow-up periods (P < 0.001) but not between post-intervention and follow-up period (P = 0.9) for both muscles. Within-group effect sizes were large (d > 1.0) for both follow-up periods in both muscles. The anova found a significant effect for time (F = 78.6; P < 0.001) for changes in pain intensity and active pain-free mouth opening (F = 17.1; P < 0.001). Significant differences were found between pre-intervention and both post-intervention and follow-up periods (P < 0.001) but not between the post-intervention and follow-up period (P > 0.7). Within-group effect sizes were large (d > 0.8) for both post-intervention and follow-up periods. The application of treatment directed at the cervical spine may be beneficial in decreasing pain intensity, increasing PPTs over the masticatory muscles and an increasing pain-free mouth opening in patients with myofascial TMD.

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Section: Discussionmentioning

confidence: 99%

The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders

Touche

Fernández‐de‐las‐Peñas

Fernández‐Carnero

et al. 2009

J of Oral Rehabilitation

128

113

View full text Add to dashboard Cite

show abstract

“…These suggest that non-opioid descending inhibitory systems are at least partly responsible for the hypoalgesic effect of manipulative interventions. Although we are limited in our extrapolations due to the limited number of manipulative interventions provided in this current study, Wright 34 has associated the absence of tolerance with repeated manual interventions to the role of descending mechanisms in manipulation-induced hypoalgesia. We acknowledge that this hypoalgesic effect is but one explanation for the observed positive outcomes on pain and mobility in the present study and that a similar study looking at specific indicators of hypoalgesia is required before strong statements in this regard are warranted.…”

Section: Discussionmentioning

confidence: 94%

Repeated Applications of Thoracic Spine Thrust Manipulation do not Lead to Tolerance in Patients Presenting with Acute Mechanical Neck Pain: A Secondary Analysis

Fernández‐de‐las‐Peñas¹,

Cleland²,

Huijbregts³

et al. 2009

Journal of Manual & Manipulative Therapy

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It has been demonstrated that patients receiving mobilization techniques do not exhibit tolerance to repeated applications. However, this phenomenon has not been investigated for thoracic manipulation. Our aim was to determine if patients receiving thoracic thrust manipulation exhibit tolerance to repeated applications in acute mechanical neck pain. Forty-five patients were randomly assigned to two groups. The control group received electro- and thermotherapy for 5 sessions, and the experimental group received the same program and also received a thoracic thrust manipulation once a week for 3 consecutive weeks. Outcome measures included neck pain and cervical mobility. Within-session change scores for pain and mobility during treatment sessions #1, 3, and 5 were examined with a one-way repeated measured ANOVA. A 2-way ANOVA with session as within-subject variable and group as between-subject variable was used to compare change scores for each visit between groups to ascertain if there were significant between-group differences in within-session changes for the experimental versus the control group. The ANOVA showed that for either group the 3 within-session change scores were not significantly different (P > 0.1). The 2-way ANOVA revealed significant differences between groups for both pain and neck mobility in within-session change scores (all, P < 0.001). Change scores in each session were superior in the experimental group as compared to those in the control group. The results suggest that patients receiving thoracic manipulation do not exhibit tolerance to repeated applications with regard to pain and mobility measures in acute mechanical neck pain. Further studies should investigate the dose-response relationship of thoracic thrust manipulation in this population.

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“…Melzack and Wall 31 in 1999 gave the theory that movement might trigger segmental inhibitory mechanisms relieving pain. Wright 32 and Souvlis et al 33 hypothesized that mobilization may activate descending pain inhibitory systems, mediated supraspinally. Improvement in outcome measure score may be explained due to improved circulation or pain gate mediated analgesia immediately following mobilization of the biomechanically impaired arthritic knee.…”

Section: Resultsmentioning

confidence: 99%

Comparison between the effects of Maitland’s mobilization versus its combination with vastus medialis oblique neuromuscular stimulation on two scales (NPRS & WOMAC) in knee osteoarthritis patients

Choudhary

Khanna

Awasthi

et al. 2022

Indian Journal of Medical Research

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Background & objectives: Osteoarthritis (OA) is the most common form of arthritis that increases with age affecting the population from the middle age to the elderly. The present study was undertaken to find whether neuromuscular stimulation of vastus medialis oblique (VMO) in combination with Maitland’s mobilization and exercises was more effective as compared to Maitland’s mobilization with exercises alone in patients with knee OA. Methods: Sixty patients with knee OA were purposively selected and randomly distributed to two groups that received an intervention for eight weeks. Group A patients received Maitland’s mobilization in combination with exercises and group B patients received the same intervention as group A in combination with neuromuscular stimulation of VMO muscle. After eight weeks, outcome measures, i.e . Numeric Pain Rating Scale (NPRS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) index, were reassessed. Results: Both groups showed significant ( P <0.05) within-group improvement in the knee pain levels and stiffness as reflected by NPRS and WOMAC index. Interpretation & conclusions: Patients of both the groups (A and B) were found to be improving significantly in pain and disability, group A patients receiving Maitland’s mobilization in combination with exercises were found to get more relief in pain and disability.

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Pain-Relieving Effects of Cervical Manual Therapy

Cited by 13 publications

References 58 publications

The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders

The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders

Repeated Applications of Thoracic Spine Thrust Manipulation do not Lead to Tolerance in Patients Presenting with Acute Mechanical Neck Pain: A Secondary Analysis

Comparison between the effects of Maitland’s mobilization versus its combination with vastus medialis oblique neuromuscular stimulation on two scales (NPRS & WOMAC) in knee osteoarthritis patients

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