Spinal manipulative therapy has an immediate effect on thermal pain sensitivity in people with low back pain: A randomized controlled trial

36 patients experiencing low back pain (LBP) were randomized to receive spinal manipulative therapy (SMT), lumbar extension exercises, or stationary bicycle treatment. This study assessed the effects of all three interventions on A-delta fiber-mediated pain perception. The results of this trial indicated that inhibition of A-delta fiber-mediated pain perception was similar across all groups. However, inhibition of temporal summation for the lower extremity was observed in patients receiving SMT only.