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Updated: May 25, 2026
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Back Mechanical Sensitivity Assessment in the Rat for Mechanistic Investigation of Chronic Back Pain
Published on: August 30, 2022
Changes in pain sensitivity following spinal manipulation: a systematic review and meta-analysis
Rogelio A Coronado1, Charles W Gay, Joel E Bialosky
1College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States. rcoronado@phhp.ufl.edu
Summary
Spinal manipulation (SMT) effectively increases pain pressure threshold, suggesting a central nervous system mechanism for pain relief. This review quanties the hypoalgesic effects of SMT on pain sensitivity.
Area of Science:
- Pain Management
- Neurology
- Musculoskeletal Health
Background:
- Spinal manipulation (SMT) is a common treatment for musculoskeletal pain.
- The precise mechanisms underlying SMT's effectiveness are not fully understood.
- Pain sensitivity testing offers a potential avenue to explore these mechanisms.
Purpose of the Study:
- To systematically review and quantify the hypoalgesic effects of SMT on pain sensitivity measures.
- To examine the existing literature on SMT and its impact on pain sensitivity.
Main Methods:
- A systematic literature search was conducted across CINAHL, MEDLINE, PsycINFO, and SPORTDiscus databases until May 2011.
- Methodological quality of included studies was assessed.
- Meta-analysis was used to pool effect size estimates for mechanical pressure pain threshold (PPT).
Main Results:
- Twenty studies met the inclusion criteria from 997 identified articles.
- SMT demonstrated a significant positive effect on increasing mechanical PPT compared to other interventions.
- Subgroup analysis indicated that SMT increased PPT at remote sites, suggesting a central nervous system effect.
Conclusions:
- SMT appears to have hypoalgesic effects, particularly on mechanical PPT.
- Evidence suggests a potential central nervous system mechanism for SMT-induced pain relief.
- Future research should employ diverse stimuli and test multiple anatomical sites to further elucidate SMT's effects.
