Manual Therapy Effects on Nonspecific Neck Pain Are Not Mediated by Mechanisms Related to Conditioned Pain Modulation: A Randomized Clinical Trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2023;11(16):11 J Clin Med. 2023 Jun 7;12(12):3894.What this means for my practice?
Although pain intensity from baseline was significantly better in the pain-free MT group, there were no substantial differences between the two groups when considering CPM, TSP, PPT, and cold pain intensity. The results of this trial were limited by a small sample size, lack of assessor blinding, and single-center trial design. Future trials should consider conducting a multi-center trial design to increase the generalizability of the results.
Study Summary
Thirty-eight patients with chronic or recurrent nonspecific neck pain were randomized to receive either painful manual therapy (MT) (n=19) or pain-free manual therapy (n=19). Outcomes of interest included pressure pain thresholds (PPT), conditioned pain modulation (CPM), temporal summation of pain (TSP), cold pain intensity, intensity of neck pain, expectations, and self-perceived improvement by Global Rating of Change (GROC). No significant differences were apparent between the two groups for all outcome measures except for pain intensity compared to baseline. Change from baseline pain intensity was significantly better in the pain-free MT group. Additionally, positive expectations were significantly higher in the painful MT group.
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