Immediate Effects of Spinal Manipulative Therapy on Regional Antinociceptive Effects in Myofascial Tissues in Healthy Young Adults
SOURCE: J Manipulative Physiol Ther. 2013 (Jul); 36 (6): 333–341 ~ FULL TEXT
John Z. Srbely, DC PhD, Howard Vernon, DC, PhD,
David Lee, DC, Miranda Polgar, BSc
Department of Human Health and Nutritional Science,
University of Guelph, Guelph,
OBJECTIVE: The purpose of this study was to investigate if spinal manipulative therapy (SMT) can evoke immediate regional antinociceptive effects in myofascial tissues by increasing pressure pain thresholds (PPTs) over myofascial trigger points in healthy young adults.
METHODS: A total of 36 participants (19 men, 17 women; age, 28.0 [5.3] years; body mass index, 26.5 [5.7] kg/m(2)) with clinically identifiable myofascial trigger points in the infraspinatus and gluteus medius muscles were recruited from the University of Guelph, Ontario, Canada. Participants were randomly allocated to 2 groups. Participants in the test group received chiropractic SMT targeted to the C5-C6 spinal segment. Participants in the control group received sham SMT. The PPT was recorded from the right infraspinatus and gluteus medius muscles at baseline (preintervention) and 1, 5, 10, and 15 minutes postintervention.
RESULTS: Three participants were disqualified, resulting in a total of 33 participants analyzed. Significant increases in the pressure pain thresholds (PPT) [decreased pain sensitivity] were observed in the test infraspinatus group when compared with test gluteus medius, control infraspinatus, and control gluteus medius groups (P < .05). No significant differences in PPT were observed at any time point when comparing test gluteus medius, control infraspinatus, and control gluteus medius groups (P > .05).
CONCLUSIONS: This study showed that SMT evokes short-term regional increases in PPT within myofascial tissues in healthy young adults.
Key Indexing Terms: Manipulation, Myofascial Pain Syndrome, Myofascial Trigger Point, Pain Threshold, Chiropractic
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Chronic myofascial pain syndrome (MPS) is one of the most commonly encountered pain conditions and represents a significant burden to our health care system. Population-based studies report that chronic regional pain, such as MPS, impacts up to 25% of the population at any given time.  The prevalence of MPS among the middle-aged population (30-60 years) is reported at 37% and 65% in men and women, respectively,  and increases to 85% in the elderly (>65 years).  Given that the elderly population is expected to double by the year 2040,  chronic MPS is poised to become one of the most significant health challenges in the future. Consequently, advancement of conservative and cost-effective therapeutic approaches is imperative to easing its impending burden on our health delivery system.