Evaluation Of A Form Of Manual Therapy ( Mt ) Affects Conditioned Pain Modulation Essay

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Specific aim: The aim of this study is to examine if spinal mobilization (SM), a form of manual therapy (MT) affects conditioned pain modulation (CPM) among adults with chronic idiopathic neck pain (CINP).

Scope of the problem: “Why is the study important?”
Chronic neck pain is common, costly, and a leading cause of disability. Literature suggests that ascending pain pathways (i.e. pain pressure threshold or PPT) and/or descending pain pathways (i.e. CPM) may be impaired in those with chronic pain [please see Appendix for illustration of ascending and descending pain pathways]. Spinal mobilization (SM), a form of MT, is a common treatment that has been effective in relieving neck pain according to Cochrane Review (Gross et al 2015). A recent systematic review (Coronado et al 2015) concluded that although the pain relief from MT seems to improve PPT; the pain relief, however, is not associated with PPT, a measure of the ascending pain pathways. Whether the pain relief from SM is due to its effects on the descending pain pathways (e.g. CPM) is not known at this time.

CPM is a method to test one’s endogenous descending pain inhibition status. It is a simple test that uses a second painful stimulus to identify if a person has a normal functioning CPM or not. Pressure pain threshold (PPT) is a measure of (ascending and descending pain pathways) pain sensitivity and is a part of the CPM testing protocol. There is research indicating that one session of MT has improved PPT and

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