Thursday, August 7, 2014

Can Spinal Manipulation Reduce Pain and Stress?


For years chiropractors observed curious responses in patients.  Not only did people often feel 'better' following treatment with often sudden reductions in pain, they would also express feelings of well being (even euphoria) and 'clear headedness' as well as being able to move more freely and this often appeared to be more prevalent following cervical or neck manipulation.
How so?

So far there have been 8 recorded neurological effects of spinal manipulation many of which 'fire' impulses into the very busy and electrically sensitive brain stem where many of our body functions are housed and where our outer 'self' is represented by the brain.  The release of hormones is a knock on effect and although how long these effects last is still a question we also understand that with repetition of such treatments positive 'plastic' brain changes occur, principally in the way the brain 'maps' the body's movements and sensations.  It is fascinating and useful information to communicate with patients that the targeted and gentle input of spine movement affects more than just 'sore backs'. It appears that it may influence the way we perceive our world.


Changes in Biochemical Markers of Pain Perception and Stress Response After Spinal Manipulation



Address correspondence to Dr Fidel Hita-Contreras, Department of Health Sciences (B-3/272). Universidad de Jaén. Campus Las Lagunillas s/n, 23071 Jaén, Spain. E-mail: 
Published: Journal of Orthopaedic & Sports Physical Therapy, 2014, Volume: 44 Issue: 4 Pages: 231-239 doi:10.2519/jospt.2014.4996
Study Design
Controlled, repeated-measures, single-blind randomized study.

Objectives
To determine the effect of cervical or thoracic manipulation on neurotensin, oxytocin, orexin A, and cortisol levels.

Background
Previous studies have researched the effect of spinal manipulation on pain modulation and/or range of movement. However, there is little knowledge of the biochemical process that supports the antinociceptive effect of spinal manipulation.

Methods
Thirty asymptomatic subjects were randomly divided into 3 groups: cervical manipulation (n = 10), thoracic manipulation (n = 10), and nonmanipulation (control) (n = 10). Blood samples were extracted before, immediately after, and 2 hours after each intervention. Neurotensin, oxytocin, and orexin A were determined in plasma using enzyme-linked immuno assay. Cortisol was measured by microparticulate enzyme immuno assay in serum samples.

Results
Immediately after the intervention, significantly higher values of neurotensin (P<.05) and oxytocin (P<.001) levels were observed with both cervical and thoracic manipulation, whereas cortisol concentration was increased only in the cervical manipulation group (P<.05). No changes were detected for orexin A levels. Two hours after the intervention, no significant differences were observed in between-group analysis.

Conclusion
The mechanical stimulus provided by spinal manipulation triggers an increase in neurotensin, oxytocin, and cortisol blood levels. Data suggest that the initial capability of the tissues to tolerate mechanical deformation affects the capacity of these tissues to produce an induction of neuropeptide expression. J Orthop Sports Phys Ther 2014;44(4):231–239. Epub 22 January 2014. doi:10.2519/jospt.2014.4996




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