Neurophysiological mechanisms of chiropractic spinal manipulation for spine pain

被引:40
|
作者
Gevers-Montoro, Carlos [1 ,2 ,3 ]
Provencher, Benjamin [1 ,2 ]
Descarreaux, Martin [1 ,4 ]
Ortega de Mues, Arantxa [3 ]
Piche, Mathieu [1 ,2 ]
机构
[1] Univ Quebec Trois Rivieres, Dept Anat, 3351 Boul Forges,CP 500, Trois Rivieres, PQ G9A 5H7, Canada
[2] Univ Quebec Trois Rivieres, CogNAC Res Grp, Trois Rivieres, PQ, Canada
[3] Madrid Coll Chiropract RCU Maria Cristina, Madrid, Spain
[4] Univ Quebec Trois Rivieres, GRAN Res Grp, Trois Rivieres, PQ, Canada
基金
加拿大健康研究院;
关键词
low back pain; manual therapy; neck pain; pain inhibition; placebo; spinal manipulative therapy; LOW-BACK-PAIN; THORACIC THRUST MANIPULATION; PLACEBO-CONTROLLED TRIAL; NECK PAIN; MANUAL THERAPY; SUBSTANCE-P; 2ND PAIN; SECONDARY HYPERALGESIA; CERVICAL MANIPULATION; CENTRAL SENSITIZATION;
D O I
10.1002/ejp.1773
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Together, neck pain and back pain are the first cause of disability worldwide, accounting for more than 10% of the total years lived with disability. In this context, chiropractic care provides a safe and effective option for the management of a large proportion of these patients. Chiropractic is a healthcare profession mainly focused on the spine and the treatment of spinal disorders, including spine pain. Basic studies have examined the influence of chiropractic spinal manipulation (SM) on a variety of peripheral, spinal and supraspinal mechanisms involved in spine pain. While spinal cord mechanisms of pain inhibition contribute at least partly to the pain-relieving effects of chiropractic treatments, the evidence is weaker regarding peripheral and supraspinal mechanisms, which are important components of acute and chronic pain. This narrative review highlights the most relevant mechanisms of pain relief by SM and provides a perspective for future research on SM and spine pain, including the validation of placebo interventions that control for placebo effects and other non-specific effects that may be induced by SM. Significance Spinal manipulation inhibits back and neck pain partly through spinal segmental mechanisms and potentially through peripheral mechanisms regulating inflammatory responses. Other mechanisms remain to be clarified. Controls and placebo interventions need to be improved in order to clarify the contribution of specific and non-specific effects to pain relief by spinal manipulative therapy.
引用
收藏
页码:1429 / 1448
页数:20
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