How does spinal manipulation affect pain perception? This is certainly a complex question! The effects of high-velocity, low-amplitude thrust manipulation have been associated with both peripheral and spinal neurophysiological responses, with evidence suggesting that manual therapies are not segmentally specific, nor do they require specificity to achieve reductions in pain or improvements in function. It is likely that thrust manipulation initiates rapid, sequential involvement of peripheral, spinal, and supraspinal neurophysiological responses which may account for the widespread effects that may or may not be distributed segmentally. As well, manual interventions have been shown to be followed by changes in serum endocannabinoids, beta-endorphins, and monoamines and may evoke descending inhibition through the interaction of neurotransmitters on subcortical and spinal cord structures. Further, preliminary functional magnetic resonance imaging (fMRI) studies have shown changes in activation of cerebral areas believed to be involved in the pain experience following thrust manipulation in healthy subjects. This study (published in JMPT - 2017) looked at differences in activation in cortical areas associated with the pain experience (specifically the insular cortex) in response to noxious stimuli in individuals with non-traumatic neck pain receiving thoracic thrust manipulation compared to those receiving sham manipulation…LOG IN OR SUBSCRIBE TO ACCESS THE COMPLETE REVIEW!
 
Pain Perception

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