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Changes in biochemical markers following a spinal manipulation - a systematic review update
Kesava Kovanur Sampath1,2, Loïc Treffel2,3,4, Oliver P Thomson2,5
1Centre for Health and Social Practice, Waikato Institute of Technology, Te Pukenga, Hamilton, New Zealand.
The Journal of Manual & Manipulative Therapy
|September 6, 2023
Summary
Spinal manipulation may affect cortisol and inflammatory markers, but evidence quality is low. More research is needed to confirm clinical relevance.
Area of Science:
- Biochemistry
- Physiology
- Evidence-based Medicine
Background:
- Spinal manipulation is a common therapeutic intervention.
- Understanding its biochemical effects is crucial for clinical application.
- Previous evidence on biochemical markers requires updating.
Approach:
- Systematic review and meta-analysis of fifteen trials (737 participants).
- Searched databases from inception to May 2023.
- Assessed risk of bias and used GRADE for evidence quality.
Key Points:
- Low-quality evidence suggests spinal manipulation may influence cortisol levels post-intervention (SMD -0.42).
- Low-quality evidence indicates potential influence on inflammatory markers like interleukins.
- Very low-quality evidence suggests no significant impact on substance-P, neurotensin, oxytocin, orexin-A, testosterone, or epinephrine/nor-epinephrine.
Conclusions:
- Spinal manipulation might impact inflammatory markers and cortisol levels.
- Wider prediction intervals highlight the need for further research.
- Clinical relevance of observed biochemical changes requires clarification.
