DOI:10.1038/s41598-019-42984-3
Keywords
1. Chiropractic care
2. Spinal manipulation
3. Pain perception
4. Pain management
5. Brain activity and chiropractic
In an intriguing development in the field of complementary medicine, a study that explores the impact of chiropractic spinal manipulation on the brain’s processing of pain highlights potential ground-breaking insights into pain management. This article delves into the nitty-gritty of the research conducted by a team whose pioneering work can reshape the understanding and treatment of chronic pain conditions.
Introduction to the Study
The study titled *The effects of chiropractic spinal manipulation on central processing of tonic pain – a pilot study using standardized low-resolution brain electromagnetic tomography (sLORETA)*, published in *Scientific Reports*, offers an innovative approach to understanding how chiropractic interventions might alter the brain’s response to pain. This comprehensive analysis involved fifteen participants with subclinical pain and utilized an intricate cross-over design contrasting chiropractic adjustments with sham sessions. The research team was spearheaded by Navid Muhammad Samran and Dina Lelic from Mech-Sense, at Aalborg University Hospital in Denmark, joined by a team from the Department of Gastroenterology and Hepatology, Centre for Chiropractic Research in New Zealand, and multiple affiliations with Dr. Imran Khan Niazi.
Methodology
The core design of the pilot study involved a cross-over comparison involving genuine chiropractic spinal adjustments and sham intervention sessions. Participants with mild experiences of recurrent spinal discomfort sans acute pain on the experiment day underwent both treatments, with a gap of 4 days on average separating the interventions.
Pain stimuli were standardized – participants immersed their left hand in 2°C water invoking tonic pain – known as the cold-pressor test, allowing for a consistent and quantifiable pain stimulus. Pain and unpleasantness ratings were captured using numerical rating scales, while 61-channel electroencephalography (EEG) recorded brain activity during resting states and pain exposition.
Crucial to the study’s analysis was the use of standardized low-resolution brain electromagnetic tomography (sLORETA), allowing researchers to pinpoint changes in brain function across various EEG frequency bands, namely delta, theta, alpha, and beta, which correspond to different states of brain activity.
Key Findings and Interpretations
A novel finding emerged indicating that after the sham intervention, there was a 9% decrease in pain scores and a 7% reduction in unpleasantness, suggesting a habituation effect to pain. Intriguingly, after real chiropractic adjustment, no such habituation was observed. The sLORETA analysis revealed decreased brain activity following tonic pain across all frequency bands after the sham intervention, while no significant change occurred post-chiropractic adjustment.
This suggests that contrary to habituation, chiropractic spinal adjustments may have a unique impact on how the central nervous system processes pain and unpleasantness. Rather than reducing the subjective experience of pain through repetition or ‘getting used to the pain,’ spinal manipulation could potentially alter the body’s central pain processing pathways, thereby changing the brain’s response to pain stimuli.
Context and Implications
Previous research highlighted in similar studies (e.g., Haavik et al., 2017; Gay et al., 2014; Teodorczyk-Injeyan et al., 2006) has suggested that spinal manipulation can influence various physiological processes, potentially impacting the sensory input from the spine to the brain. However, understanding the central mechanisms remained nebulous until now.
This investigation shines a light on the possibility that chiropractic adjustments might facilitate a form of central modulation of pain, providing a new window into the broad applications of chiropractic care beyond merely addressing spinal alignment and musculoskeletal discomfort.
Limitations and Future Studies
As a pilot study, it should be noted that the sample size was relatively small and focused on individuals with subclinical pain. To translate these insights into treatment protocols for chronic pain sufferers, more extensive research with diverse populations is essential.
Further exploration could illuminate the long-term effects of chiropractic care on central pain processing and whether adjustments yield cumulative benefits over time. Additional high-powered studies should aim to replicate these findings and discern the mechanisms underlying the distinct central responses to sham versus actual chiropractic interventions.
Expert Commentary
“The findings from this study are both important and intriguing,” states Heidi Haavik, one of the researchers involved. “By establishing a link between spinal manipulation and brain activity related to pain processing, we’re opening new doors for understanding and treating chronic pain.”
Experts in the field of pain research and neuroscience are keenly interested in these results, as they provoke questions about the potential role of chiropractic care in broader health care strategies. The integration of treatments that influence brain processing could revolutionize the current pain management paradigm.
Conclusion
This valuable inquiry provides preliminary evidence that chiropractic spinal manipulation may uniquely alter brain activity and the central processing of pain. Although at an early stage, this research beckons a re-evaluation of chiropractic’s role in pain management and the potential neuromodulatory effects of spinal adjustments.
References
1. Samran, N., Lelic, D., Niazi, I. K., Holt, K., Bolvig Mark, E., Drewes, A. M., & Haavik, H. (2019). The effects of chiropractic spinal manipulation on central processing of tonic pain – a pilot study using standardized low-resolution brain electromagnetic tomography (sLORETA). *Scientific Reports*, 9, Article number: 6925.(https://doi.org/10.1038/s41598-019-42984-3)
2. Haavik, H., et al. (2017). Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in Chronic Pain Patients: A Preliminary Study. *Journal of Manipulative and Physiological Therapeutics*, 40, 127–138.(https://doi.org/10.1016/j.jmpt.2016.10.002)
3. Gay, C. W., Robinson, M. E., George, S. Z., Perlstein, W. M., & Bishop, M. D. (2014). Immediate changes after manual therapy in resting-state functional connectivity as measured by functional magnetic resonance imaging in participants with induced low back pain. Journal of Manipulative and Physiological Therapeutics, 37, 614–627. (https://doi.org/10.1016/j.jmpt.2014.09.001)
4. Teodorczyk-Injeyan, J. A., Injeyan, H. S., & Ruegg, R. (2006). Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. Journal of Manipulative and Physiological Therapeutics, 29, 14–21.(https://doi.org/10.1016/j.jmpt.2005.10.002)
5. Haavik, H., & Murphy, B. (2012). The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. Journal of Electromyography and Kinesiology, 22, 768–776. (https://doi.org/10.1016/j.jelekin.2012.02.012)
This ground-breaking inquiry not only contributes significantly to the understanding of pain modulation but also suggests a potentially transformative role for chiropractic interventions in pain therapy – a beacon of hope for millions grappling with chronic pain conditions.