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Spinal Manipulation Reduces Pain and Hyperalgesia After Lumbar Intervertebral Foramen Inflammation in the Rat
A review of
Song et al. (2006) Spinal Manipulation Reduces Pain and Hyperalgesia After Lumbar Intervertebral Foramen Inflammation in the Rat. Journal of Manipulative and Physiological Therapeutics Vol 29, Number 1.
Research Reviewed by Dr. Anthony Vasile
Summarized Review of Conclusion:
The study shows that spinal manipulation therapy (SMT) can reduce the time of pain and sensitivity to pain by half compared to just waiting for the pain to resolve on its own. This effect lasted well beyond the intervention period of the study. The effects of the SMT did not only reduce the pain but it effected the underlying cause of the pain which is inflammation. By reducing the exposure to the harmful chemicals released from inflammation this helps prevent the chances of the acute pain progressing to chronic pain. This faster elimination of pain and inflammation was partially due to the improvement of blood flow and nutrition to the dorsal root ganglion within the affected intervertebral foramen. Simply put, the adjustment helped the rats feel better in half the time. After an injury the faster and more constant adjustments one can receive the faster they will feel better. This is especially important in the first 2 weeks following the injury. This is precisely why we have our patients come in everyday for the first 2 weeks or 10 visits then 3 times a week the following weeks until a progress exam. This fits perfectly into the results of this study.
Below I have referenced key quotes from this research to help summarize the results.
Quotes from the Article:
“The present study shows that ASMT can significantly reduce the severity and shorten the duration of pain and hyperalgesia [and allodynia] caused by lumbar IVF inflammation. This effect may result from the adjustment-induced faster elimination of the inflammation and recovery of excitability of the inflamed DRG neurons.”
“The ASMT may produce more movement of the affected intervertebral joints (facets), which may improve blood and nutrition supply to the DRG within the affected IVF.”
“A series of 10 adjustments were initiated 24 hours after surgery (to mimic acute spinal injury) and subsequently applied for 7 consecutive days and every other day during the second week.”
“ASMT applied on the spinous process significantly reduced the IVF inflammation-induced thermal hyperalgesia and mechanical allodynia in severity and duration. Severity of thermal hyperalgesia started to decrease significantly on the fourth post-injection day, that is, after 3 adjustments, evidenced by the increased latency of foot withdrawal to heat stimulation.”
“Duration of hyperalgesia was shortened to 2 to 3 weeks in the animals that received adjustments as compared with 4 to 5 in the control.”
“ASMT applied on L5, L6, or both L5 and L6, but not L4, produced similar effects on the mechanical allodynia. The treatments reduced the severity and shortened duration of allodynia to 10 to 14 days from 3 to 4 weeks.”
“Two to 4 weeks after ASMT treatments, the increased excitability of the sensory neurons decreased and recovered significantly compared with those without treatment.”
Introduction to the Research
The purpose of this research was intended to investigate the effects of instrumented assisted spinal manipulation therapy (ASMT) on pain and hyperalgesia produced by acute IVF inflammation in L5 in a small animal model. IVF inflammation is one of the main reasons for low back pain.
The IVF inflammation was mimicked by in vivo delivery of inflammatory soup directly into the L5 IVF in adult male Sprague-Dawley rats. Thermal hyperalgesia and mechanical allodynia were determined by the shortened latency of foot withdrawal to radiant heat and von Frey filament stimulation to the hind paw, respectively. Intracellular recordings were obtained in vitro from L5 dorsal root ganglion (DRG) somata. DRG inflammation was examined by observation of the appearance and hematoxylin and eosin staining. ASMT was applied to the spinous process of L4, L5, and L6. A series of 10 adjustments were initiated 24 hours after surgery and subsequently applied daily for 7 consecutive days and every other day during the second week.
ASMT applied on L5, L6, or L5 and L6 spinous process significantly reduced the severity and duration of thermal and mechanical hyperalgesia produced by the IVF inflammation. However, ASMT applied on L4 did not affect the response in rats with IVF inflammation or the controls.
Electrophysiological studies showed that hyperexcitability of the DRG neurons produced by IVF inflammation was significantly reduced by ASMT.
Pathological studies showed that manifestations of the DRG inflammation, such as the increased vascularization and satellitosis, were significantly reduced 2 to 3 weeks after ASMT.
What this means is that the spinal manipulation reduces the amount of time inflammation and pain occurs. This results in less time tissues being exposed to harmful chemicals which lessens the chance of the pain going from acute to chronic. This is an amazing study with clinical significance.
This article a great reminder that chiropractic is safe, effective and cost efficient. Continue to take care of yourself by eating, moving and thinking in ways that bring you to a state of homeostasis. Keep your spine healthy and moving with regular chiropractic adjustments.
As always with these reviews, these are my takeaways from the article and I encourage you to read the article in its entirety. The references used in this article by the authors of this article are listed here.
At our McKinney location, located near the corner of Eldorado Pkwy. and Ridge Rd., we are here to help you get out of pain! Our Chiropractors will relieve your pain through Chiropractic adjustments and teaching the proper form for exercises. We also look at nutrition to make sure you are getting the proper nutrients while helping you manage stress to give your body the best fighting chance against pain and disease!