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The effect of lumbar spinal manipulation upon local and remote deep and superficial pain perception

Dorron, Sasha (2015) The effect of lumbar spinal manipulation upon local and remote deep and superficial pain perception. Honours thesis, Murdoch University.

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Introduction: The mechanism for pain relief associated with spinal manipulation (SM) is not well understood. Cervical SM decreases pressure sensitivity in the cervical spine and upper limb for at least 10 minutes. Lumbar spine studies to date have demonstrated no effect.

Objectives: To determine whether lumbar SM has an effect on pressure pain threshold (PPT) and pinprick sensitivity (PPS) at local and remote locations, the duration of any change, and whether changes are related to the side of SM.

Methods: 34 asymptomatic participants, mean age 22.56 years (SD 3.99), were randomised to receive a lumbar SM on the right or left side. PPT and PPS were measured bilaterally at the calf, lumbar spine, scapula, and forehead at baseline, immediately post-SM, and after 10, 20, and 30 minutes. Effects of SM on PPT and PPS were investigated in repeated-measures ANOVAs.

Results: Calf and lumbar spine PPT increased bilaterally at 10, 20 and 30 minutes (7.2 - 11.8% changes). PPS decreased in all locations at various times (9.8 – 22.5% changes). For the calf and lumbar spine, increases in PPT tended to be greater on the side of SM compared to contralaterally, although this varied over the follow-up period. Throughout the experiment, the left lumbar spine and calf were more sensitive to pressure than the right, whereas the right calf and forehead were more sensitive to pinprick than the left.

Conclusion: Lumbar SM appears to reduce pressure sensitivity locally and in the lower limb for at least 30 minutes. These findings contradict prior lumbar spine studies, but are consistent with cervical spine studies. The observed changes in pressure sensitivity may reflect local spinal or complex supraspinal analgesic mechanisms. Pinprick sensitivity was reduced globally, and likely represents a non-specific effect. However, a lack of control/sham limits the strength of the conclusions.

Item Type: Thesis (Honours)
Murdoch Affiliation(s): School of Health Professions
Supervisor(s): Losco, Barrett, Drummond, Peter and Walker, Bruce
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