Immediate effects of spinal manipulation on nitric oxide,substance P and pain perception |
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| Institution: | 1. Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain;2. Department of Physical Medicine and Rehabilitation, Complutense University School of Medicine, Avda. de Séneca, 2. Ciudad Universitaria, 28040 Madrid, Spain;1. Graduate Sciences Education, Faculty of Medicine, University of Calgary, Calgary, AB, Canada;2. School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia;3. Department of Surgery, Faculty of Medicine, University of Calgary, Calgary, AB, Canada;4. Sport Injury Prevention Research Center, University of Calgary, Calgary, AB, Canada;5. Alberta Health Services Research - Research Excellence Support Team, Foothills Medical Center, Calgary, AB, Canada;6. Division of Physical Therapy, Walsh University, North Canton, OH;7. Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, AB, Canada;1. The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, Brisbane, Queensland, Australia;2. Ghent University, Department of Rehabilitation Sciences and Physiotherapy, Ghent, Belgium;1. School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, PO Box 456, Brisbane, Virginia, QLD 4014, Australia;2. The University of Queensland, School of Information Technology and Electrical Engineering, Brisbane, Australia;3. Brisbane Orthopaedic & Sports Medicine Centre, Brisbane, Australia;1. A.T. Still Research Institute, A.T. Still University, 800 West Jefferson Street, Kirksville, MO 63501, USA;2. A.T. Still University, 5850 E. Still Circle, Mesa, AZ, 85206, USA;3. Clinical Pharmacology Unit, Inserm CIC1406, Grenoble University Hospital, Grenoble, France;4. UMR 1042 – HP2, Inserm and University of Grenoble-Alpes, Grenoble, France;5. A.T. Still University-Kirksville College of Osteopathic Medicine, 800 W. Jefferson St., Kirksville, MO, 63501, USA;1. Rehabilitación San Fernando, Madrid, Spain;2. Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain;3. Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain;4. Department of Physical Therapy, Franklin Pierce University, Manchester, NH, USA;5. Rehabilitation Services, Concord Hospital, Concord, NH, USA;6. Manual Therapy Fellowship Program, Regis University, Denver, CO, USA;7. Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain;8. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain;9. Clínica de Investigación Fisioterapia y Dolor, Fundación General de la Universidad de Alcalá, Alcalá de Henares, Spain |
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| Abstract: | Previous studies have analyzed the effects of spinal manipulation on pain sensitivity by using several sensory modalities, but to our knowledge, no studies have focused on serum biomarkers involved in the nociceptive pathway after spinal manipulation. Our objectives were to determine the immediate effect of cervical and dorsal manipulation over the production of nitric oxide and substance P, and establishing their relationship with changes in pressure pain thresholds in asymptomatic subjects. In this single-blind randomized controlled trial, 30 asymptomatic subjects (16 men) were randomly distributed into 3 groups (n = 10 per group): control, cervical and dorsal manipulation groups. Blood samples were extracted to obtain serum. ELISA assay for substance P and chemiluminescence analysis for nitric oxide determination were performed. Pressure pain thresholds were measured with a pressure algometer at the C5–C6 joint, the lateral epicondyle and the tibialis anterior muscle. Outcome measures were obtained before intervention, just after intervention and 2 h after intervention. Our results indicated an increase in substance P plasma level in the cervical manipulation group (70.55%) when compared with other groups (p < 0.05). This group also showed an elevation in the pressure pain threshold at C5–C6 (26.75%) and lateral epicondyle level (21.63%) immediately after the intervention (p < 0.05). No changes in nitric oxide production were observed. In conclusion, mechanical stimulus provided by cervical manipulation increases substance P levels and pressure pain threshold but does not change nitric oxide concentrations. Part of the hypoalgesic effect of spinal manipulation may be due to the action of substance P. |
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| Keywords: | Spinal manipulation Substance P Nitric oxide Pressure pain threshold |
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