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Chiropractic & Manual Therapies

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Open Access 01-12-2012 | Systematic review

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

Authors: Mario Millan, Charlotte Leboeuf-Yde, Brian Budgell, Michel-Ange Amorim

Published in: Chiropractic & Manual Therapies | Issue 1/2012

Abstract

Background

Although 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.

Objectives

To 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.

Design

A systematic critical literature review.

Methods

A 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.

Results

Twenty-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.

Conclusions

These 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.

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Title: The effect of spinal manipulative therapy on experimentally induced pain: a systematic literature review
Authors: Mario Millan
Charlotte Leboeuf-Yde
Brian Budgell
Michel-Ange Amorim
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Chiropractic & Manual Therapies / Issue 1/2012
Electronic ISSN: 2045-709X
DOI: https://doi.org/10.1186/2045-709X-20-26

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Objectives

Design

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objectives

Design

Methods

Results

Conclusions

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