Restoration of normal central pain processing following manual therapy in nonspecific chronic neck pain

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dc.contributor.authorZabala Mata, Josu
dc.contributor.authorAzkue Barrenetxea, Jon Jatsu
dc.contributor.authorBialosky, Joel E.
dc.contributor.authorSaez, Marc
dc.contributor.authorDomínguez López, Estíbaliz
dc.contributor.authorAraolaza Arrieta, Maialen
dc.contributor.authorLascurain-Aguirrebeña, Ion
dc.date.accessioned2024-11-22T09:13:24Z
dc.date.available2024-11-22T09:13:24Z
dc.date.issued2024-05
dc.date.updated2024-11-22T09:13:24Z
dc.description.abstractObjective To determine if a 4-week manual therapy treatment restores normal functioning of central pain processing mechanisms in non-specific chronic neck pain (NSCNP), as well as the existence of a possible relationship between changes in pain processing mechanisms and clinical outcome. Design Cohort study. Methods Sixty-three patients with NSCNP, comprising 79% female, with a mean age of 45.8 years (standard deviation: 14.3), received four treatment sessions (once a week) of manual therapy including articular passive mobilizations, soft tissue mobilization and trigger point treatment. Pressure pain thresholds (PPTs), conditioned pain modulation (CPM) and temporal summation of pain (TSP) were evaluated at baseline and after treatment completion. Therapy outcome was measured using the Global Rating of Change Scale (GROC), the Neck disability Index (NDI), intensity of pain during the last 24 hours, Tampa Scale of Kinesiophobia (TSK) and Pain Catastrophizing Scale (PCS). Two sets of generalized linear mixed models with Gaussian response and the identity link were employed to evaluate the effect of the intervention on clinical, psychological and psychophysical measures and the association between psychophysical and clinical outcomes. Results Following treatment, an increased CPM response (Coefficient: 0.89; 95% credibility interval = 0.14 to 1.65; P = .99) and attenuated TSP (Coefficient: -0.63; 95% credibility interval = -0.82 to -0.43; P = 1.00) were found, along with amelioration of pain and improved clinical status. PPTs at trapezius muscle on the side of neck pain were increased after therapy (Coefficient: 0.22; 95% credibility interval = 0.03 to 0.42; P = .98), but not those on the contralateral trapezius and tibialis anterior muscles. Only minor associations were found between normalization of TSP/CPM and measures of clinical outcome. Conclusion Clinical improvement after manual therapy is accompanied by restoration of CPM and TSP responses to normal levels in NSCNP patients. The existence of only minor associations between changes in central pain processing and clinical outcome suggests multiple mechanisms of action of manual therapy in NSCNP.en
dc.identifier.citationMata, J. Z., Azkue, J. J., Bialosky, J. E., Saez, M., López, E. D., Arrieta, M. A., & Lascurain-Aguirrebeña, I. (2024). Restoration of normal central pain processing following manual therapy in nonspecific chronic neck pain. PLoS ONE, 19(5). https://doi.org/10.1371/JOURNAL.PONE.0294100
dc.identifier.doi10.1371/JOURNAL.PONE.0294100
dc.identifier.eissn1932-6203
dc.identifier.urihttp://hdl.handle.net/20.500.14454/2084
dc.language.isoeng
dc.publisherPublic Library of Science
dc.rights© 2024 Mata et al.
dc.titleRestoration of normal central pain processing following manual therapy in nonspecific chronic neck painen
dc.typejournal article
dcterms.accessRightsopen access
oaire.citation.issue5
oaire.citation.titlePLoS ONE
oaire.citation.volume19
oaire.licenseConditionhttps://creativecommons.org/licenses/by/4.0/
oaire.versionVoR
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