Spinal manipulation does not affect pressure pain thresholds in the absence of neuromodulators: a randomized controlled trial

Abstract

This study suggests that in young adults who do not have current or recent symptoms of spinal pain, multiple within-session treatments of cervical and lumbar spinal manipulation fail to influence PPTs. Changes in PPT that are observed in symptomatic individuals are likely to be primarily influenced by pain-related neuromodulators rather than by an isolated, mechanical effect of spinal manipulation.

Neurophysiological mechanisms of chiropractic spinal manipulation for spine pain

“…However, PPTs were significantly increased immediately after SM at the most sensitive segment (Nim et al., 2020). This supports the segmental effects of SM on pain‐related processes, which may rely on the modulation of central sensitization (Jordon et al., 2017), as discussed below.…”

Duration of Electro-Dry Needling Does Not Change the Pain Response After Repeated Nociceptive Thermal Stimuli in Asymptomatic Individuals: A Randomized Intervention Study

“…Previous studies have shown that individuals with cLBP often respond differently than asymptomatic individuals to symptom-modulating interventions. For example, while spinal manipulation seems to have minimal effect on pressure-pain thresholds (PPTs) in asymptomatic individuals, 32 , 33 it routinely increases PPT in individuals with chronic pain. 34 , 35 , 36 However, the response to manual therapy on dynamic measures of pain regulation seem to be more consistent.…”