Manipulation-induced hypoalgesia in musculoskeletal pain populations: A systematic critical review and meta-analysis

Sasha L Aspinall; Charlotte Leboeuf-Yde; Sarah J Etherington; Bruce F Walker

doi:10.1186/s12998-018-0226-7

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Manipulation-induced hypoalgesia in musculoskeletal pain populations: A systematic critical review and meta-analysis

Journal article

Open access

Manipulation-induced hypoalgesia in musculoskeletal pain populations: A systematic critical review and meta-analysis

Sasha L Aspinall, Charlotte Leboeuf-Yde, Sarah J Etherington and Bruce F Walker

Chiropractic & Manual Therapies, Vol.27, 7

2019

DOI: https://doi.org/10.1186/s12998-018-0226-7

PMCID: PMC6350309

PMID: 30719281

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Abstract

Adult

adverse effects

Aged

epidemiology

Female

Humans

Hypesthesia

Hypoalgesia

Male

Manipulation, Chiropractic

Middle Aged

Musculoskeletal pain

Pain sensitivity

Pain Threshold

psychology

Quantitative sensory testing

Spinal manipulative therapy

Background Manipulation-induced hypoalgesia (MIH) represents reduced pain sensitivity following joint manipulation, and has been documented in various populations. It is unknown, however, whether MIH following high-velocity low-amplitude spinal manipulative therapy is a specific and clinically relevant treatment effect. Methods This systematic critical review with meta-analysis investigated changes in quantitative sensory testing measures following high-velocity low-amplitude spinal manipulative therapy in musculoskeletal pain populations, in randomised controlled trials. Our objectives were to compare changes in quantitative sensory testing outcomes after spinal manipulative therapy vs. sham, control and active interventions, to estimate the magnitude of change over time, and to determine whether changes are systemic or not. Results Fifteen studies were included. Thirteen measured pressure pain threshold, and four of these were sham-controlled. Change in pressure pain threshold after spinal manipulative therapy compared to sham revealed no significant difference. Pressure pain threshold increased significantly over time after spinal manipulative therapy (0.32 kg/cm2, CI 0.22–0.42), which occurred systemically. There were too few studies comparing to other interventions or for other types of quantitative sensory testing to make robust conclusions about these. Conclusions We found that systemic MIH (for pressure pain threshold) does occur in musculoskeletal pain populations, though there was low quality evidence of no significant difference compared to sham manipulation. Future research should focus on the clinical relevance of MIH, and different types of quantitative sensory tests. Trial registration Prospectively registered with PROSPERO (registration CRD42016041963).

Details

Title: Manipulation-induced hypoalgesia in musculoskeletal pain populations: A systematic critical review and meta-analysis
Authors/Creators: Sasha L Aspinall
Charlotte Leboeuf-Yde
Sarah J Etherington
Bruce F Walker
Publication Details: Chiropractic & Manual Therapies, Vol.27, 7
Publisher: BioMed Central Ltd as Part of Springer Nature.
Identifiers: 991005586661707891
Murdoch Affiliation: School of Allied Health; School of Medical, Molecular and Forensic Sciences
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.129 Back pain; 1.129.98 Low Back Pain
Web Of Science research areas: Rehabilitation
ESI research areas: Clinical Medicine