Related Experiment Video
Updated: Jan 11, 2026

Manual Therapy for a Chronic Non-Specific Low Back Pain Rat Model
Published on: August 11, 2023
Effect of Manual Therapy on Pain Processing in People With Knee Osteoarthritis:A Systematic Review
Paula Fernanda Sávio Ribeiro1, Adriane A Alves1, Marcos Amaral de Noronha2
1Department of Physical Therapy, São Carlos, SP, Brazil.
Objective:
The purpose of this systematic review was to determine the effect of manual therapy techniques on pain processing in individuals with knee osteoarthritis (KOA).
Methods:
We conducted a comprehensive search across electronic databases through June 2023, including CENTRAL, Medline, Embase, CINAHL, and PEDro. Only randomized controlled trials were considered, and methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale.
Results:
Four studies met the inclusion criteria and underwent full reading and critical analysis. The methodological quality of these studies was rated from good to excellent. Two of 4 studies showed favorable results for manual therapy. Pain processing was assessed using pressure pain threshold, but the results of the included studies were inconclusive, failing to demonstrate a significant change in pressure pain threshold due to manual therapy techniques.
Conclusion:
The limited number of studies and substantial variation in techniques used may have contributed to the lack of positive outcomes and therefore the findings are limited. No studies investigated alternative forms of pain processing beyond pressure pain threshold.

