Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 19951
  Title The influence of expectation on spinal manipulation induced hypoalgesia: An experimental study in normal subjects
URL http://dx.doi.org/10.1186/1471-2474-9-19
Journal BMC Musculoskel Disord. 2008 ;9(1):Online access only
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Peer Review Yes
Publication Type Article
Abstract/Notes BACKGROUND: The mechanisms thorough which spinal manipulative therapy (SMT) exerts clinical effects are not established. A prior study has suggested a dorsal horn modulated effect; however, the role of subject expectation was not considered. The purpose of the current study was to determine the effect of subject expectation on hypoalgesia associated with SMT.

METHODS: Sixty healthy subjects agreed to participate and underwent quantitative sensory testing (QST) to their leg and low back. Next, participants were randomly assigned to receive a positive, negative, or neutral expectation instructional set regarding the effects of a specific SMT technique on pain perception. Following the instructional set, all subjects received SMT and underwent repeat QST.

RESULTS: No interaction (p= 0.38) between group assignment and pain response was present in the lower extremity following SMT; however, a main effect (p< 0.01) for hypoalgesia was present. A significant interaction was present between change in pain perception and group assignment in the low back (p= 0.01) with participants receiving a negative expectation instructional set demonstrating significant hyperalgesia (p< 0.01).

CONCLUSIONS: The current study replicates prior findings of c- fiber mediated hypoalgesia in the lower extremity following SMT and this occurred regardless of expectation. A significant increase in pain perception occurred following SMT in the low back of participants receiving negative expectation suggesting a potential influence of expectation on SMT induced hypoalgesia in the body area to which the expectation is directed.

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