伤害
痛觉减退
医学
止痛药
机制(生物学)
抑制性突触后电位
神经科学
导水管周围灰质
物理医学与康复
刺激(心理学)
痛觉过敏
麻醉
中脑
心理学
中枢神经系统
认识论
内科学
哲学
受体
心理治疗师
作者
Christos Savva,Giannis Giakas,Michalis Efstathiou
出处
期刊:Journal of Back and Musculoskeletal Rehabilitation
[IOS Press]
日期:2014-11-05
卷期号:27 (4): 377-382
被引量:31
摘要
Although the antinociceptive effect of high-velocity, low amplitude thrust manipulation (HVLAM) has been recognized by numerous systematic reviews, the underlying mechanism for manipulation-related pain relief remains poorly understood. An increasing number of studies have explored its analgesic mechanism suggesting that the excitation of the descending inhibitory pain mechanism (DIPM) might play the most important role for musculoskeletal pain relief.The objective of this review is to investigate the role of the DIPM in musculoskeletal pain following HVLAM as well as to identify the pain-relieving importance of this technique within clinical practice.English literature databases were searched to find studies related to the objective of the present review.Findings from current literature support that HVLAM has a profound influence on nociceptive stimulus via the possible activation of the DIPM. It seems that the application of this technique activates the periaqueductal gray region area of the midbrain, stimulates the noradrenergic descending system and at the level of the spinal cord, the nociceptive afferent barrage is reduced and mechanical hypoalgesia is induced. However, the literature on HVLAM induced-analgesia is still problematic regarding the methodological design of the existing research. Despite these limitations, the clinical importance of the activation of the DIPM should not be ignored since the resulted analgesic effect of this technique can provide a window of opportunity to restore impaired physical performance and disability.
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