Journal of Manipulative and Physiological Therapeutics
Volume 31, Issue 9 , Pages 675-681 , November 2008

Immediate Hypoalgesic and Motor Effects After a Single Cervical Spine Manipulation in Subjects With Lateral Epicondylalgia

  • Josué Fernández-Carnero, PT

      Affiliations

    • Professor, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
    • Clinical Researcher, Esthesiology Laboratory of Universidad Rey Juan Carlos, Alcorcón, Spain
    • Corresponding Author InformationSubmit requests for reprints to: Josué Fernández Carnero, PT, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
  • ,
  • Cesar Fernández-de-las-Peñas, PT, PhD

      Affiliations

    • Professor, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
    • Clinical Researcher, Esthesiology Laboratory of Universidad Rey Juan Carlos, Alcorcón, Spain
  • ,
  • Joshua A. Cleland, PT, PhD

      Affiliations

    • Professor, Department of Physical Therapy, Franklin Pierce College, Concord, NH
    • Clinical Assistant, Physical Therapist, Rehabilitation Services, Concord Hospital, NH
    • Clinical Researcher, Manual Therapy Fellowship Program, Regis University, Denver, Colo

Received 31 March 2008 ,Revised 4 September 2008 ,Accepted 8 September 2008.

References 

  1. Sran M, Souvlis T, Vicenzino B, Wright A. Characterisation of chronic lateral epicondylalgia using the McGill pain questionnaire, visual analog scales, and quantitative sensory tests. Pain Clin. 2002;13:251–259
  2. Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies: update and implications for clinical management. Sports Med. 1999;27:393–408
  3. Nirschl RP, Pettrone FA. Tennis elbow: the surgical treatment of lateral epicondylitis. J Bone Joint Surg (Am). 1979;61:832–839
  4. Nirschl RP. Elbow tendonitis/tennis elbow. Clin Sports Med. 1992;11:851–870
  5. Wright A, Thurnwald P, O'Callaghan J, Smith J, Vicenzino B. Hyperalgesia in tennis elbow patients. J Musculoskeletal Pain. 1994;2:83–97
  6. Vicenzino B, Paungmali A, Buratowski S, Wright A. Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia. Man Ther. 2001;6:205–212
  7. Paungmali A, O'Leary S, Souvlis T, Vicenzino B. Naxolone fails to antagonize initial hypoalgesic effect of a manual therapy treatment for lateral epicondylalgia. J Manipulative Physiol Ther. 2004;27:180–185
  8. Paungmali A, Vicenzino B, Smith M. Hypoalgesia induced by elbow manipulation in lateral epicondylalgia does not exhibit tolerance. J Pain. 2003;4:448–454
  9. Chiu T, Wright A. To compare the effects of different rates of application of a cervical mobilisation technique on sympathetic outflow to the upper limb in normal subjects. Man Ther. 1996;1:198–203
  10. Vicenzino B, Collins D, Benson H, Wright A. An investigation of the interrelationship between manipulative induced-induced hypoalgesia and sympatho-excitation. J Manipulative Physiol Ther. 1998;21:448–453
  11. Sterling M, Jull G, Wright A. Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity. Man Ther. 2001;6:72–81
  12. Skyba DA, Radhakrishnan R, Rohlwing JJ, Wright A, Sluka KA. Joint manipulation reduces hyperalgesia by activation of monoamine receptors but not opioid or GABA receptors in the spinal cord. Pain. 2003;106:159–168
  13. Bandler R, Keay KA. Columnar organisation in the midbrain periaqueductal gray and the integration of emotional expression. Prog Brain Res. 1996;107:285–300
  14. Souvlis T, Vicenzino B, Wright A. Neuro-physiological effects of spinal manual therapy. In:  Boyling J,  Jull G editor. Grieves' modern manual therapy: the vertebral column. 3rd ed.. Edinburgh: Churchill-Livingstone; 2004;p. 367–379
  15. Wright A. Pain-relieving effects of cervical manual therapy. In:  Grant R editors. Physical therapy of the cervical and thoracic spine. New York: Churchill-Livingstone; 2002;p. 217–238
  16. Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain. 1996;68:69–74
  17. Paungmali A, O'Leary S, Souvlis T, Vicenzino B. Hypoalgesic and sympatho-excitatory effects of mobilization with movement for lateral epicondylalgia. Phys Ther. 2003;83:374–383
  18. Bolton P, Budgell B. Spinal manipulation and spinal mobilization influence different axial sensory beds. Med Hypotheses. 2006;66:258–262
  19. Vernon H. Qualitative review of studies of manipulation-induced hypoalgesia. J Manipulative Physiol Ther. 2000;23:134–138
  20. Fernández-de-las-Peñas C, Pérez-de-Heredia M, Brea-Rivero M, Miangolarra-Page JC. Immediate effects on pressure pain threshold following a single cervical spine manipulation in healthy subjects. J Orthop Sports Phys Ther. 2007;37:325–329
  21. Fernández-de-las-Peñas C, Alonso-Blanco C, Cleland JA, Rodríguez-Blanco C, Alburquerque-Sendín F. Changes in pressure pain thresholds over C5-C6 zygapophyseal joint following a cervico-thoracic junction manipulation in healthy subjects. J Manipulative Physiol Ther. 2008;31:332–337
  22. Haker E. Lateral epicondylalgia: diagnosis, treatment and evaluation. Crit Rev Phys Medi. 1993;5:129–154
  23. Magarey ME, Rebbeck T, Coughlan B, et al. Pre-manipulative testing of the cervical spine review, revision and new clinical guidelines. Man Ther. 2004;9:95–108
  24. Fischer AA. Application of pressure algometry in manual medicine. J Man Med. 1990;5:145–150
  25. Vanderweeen L, Oostendorp RB, Vaes P, Duquet W. Pressure algometry in manual therapy. Man Ther. 1996;1:258–265
  26. Park R, Wallace M, Schuheis G. Relative sensitivity to alfentanil and reliability of current perception threshold vs. von Frey tactile stimulation and thermal sensory testing. J Peripher Nerv Syst. 2001;6:232–240
  27. Bohannon RW. Inter-tester reliability of hand-held dynamometry: a concise summary of published research. Percept Mot Skills. 1999;88:899–902
  28. Pienimäki TT, Tarvainen TK, Siira PT, Vanharanta H. Progressive strengthening and stretching exercises and ultrasound for chronic lateral epicondylitis. Physiotherapy. 1996;82:522–530
  29. Wuori JL, Overend TJ, Kramer JF, MacDermid J. Strength and pain measures associated with lateral epicondylitis bracing. Arch Phys Med Rehabil. 1998;79:832–837
  30. Stratford P. Evaluative properties of measures used to assess patients with lateral epicondylitis at the elbow. Physiother Can. 1993;45:160–164
  31. Gibbons P, Tehan P. Manipulation of the spine, thorax and pelvis. Edinburgh: Churchill Livingstone; 2000;
  32. Koltyn K. Analgesia following exercise. Sports Medicine. 2000;29:58–98
  33. Pickar J. Neurophysiological effects of spinal manipulation. Spine J. 2002;2:357–371
  34. Song XJ, Gan Q, Cao JL, Wang ZB, Rupert RL. Spinal manipulation reduces pain and hyperalgesia after lumbar inter-vertebral foramen inflammation in the rat. J Manipulative Physiol Ther. 2006;29:5–13
  35. Suter E, McMorland G. Decrease in elbow flexor inhibition after cervical spine manipulation in patients with chronic neck pain. Clin Biomech. 2002;17:541–544
  36. Taylor HH, Murphy B. Altered sensorimotor integration with cervical spine manipulation. J Manipulative Physiol Ther. 2008;31:115–126
  37. Brenner AK, Gill NW, Buscema CJ, et al. Improved activation of lumbar multifidus following spinal manipulation: a case report applying rehabilitative ultrasound imaging. J Orthop Sports Phys Ther. 2007;37:613–619
  38. Gill NW, Teyhen DS, Lee IE. Improved contraction of the transversus abdominis immediately following spinal manipulation: a case study using real-time ultrasound imaging. Man Ther. 2007;12:280–285
  39. Raney NH, Teyhen DS, Childs J. Observed changes in lateral abdominal muscle thickness after spinal manipulation: a case series using rehabilitative ultrasound imaging. J Orthop Sports Phys Ther. 2007;37:472–479
  40. Abbott JH, Patla CE, Jensen RH. The initial effects of an elbow mobilization with movement technique on grip strength in subjects with lateral epicondylalgia. Man Ther. 2001;6:163–169
  41. Vicenzino B, Cleland JA, Bisset L. Joint manipulation in the management of lateral epicondylalgia: a clinical commentary. J Man Manipulative Ther. 2007;15:50–56
  42. Stratford P, Levy DR. Assessing valid change over time in patients with lateral epicondylitis at the elbow. Clin J Sports Med. 1994;4:88–91
  43. Cleland JA, Flynn TW, Palmer JA. Incorporation of manual therapy directed at the cervico-thoracic spine in patients with lateral epicondylalgia: a pilot clinical trial. J Man Manipulative Ther. 2005;13:143–151

PII: S0161-4754(08)00275-3

doi: 10.1016/j.jmpt.2008.10.005

Journal of Manipulative and Physiological Therapeutics
Volume 31, Issue 9 , Pages 675-681 , November 2008