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. 2024 Jun 22;13(13):3648.
doi: 10.3390/jcm13133648.

CPM-Related Mechanisms Could Play a Key Role in the Effects on Pain Sensitivity Induced by Manual Therapy: Three Crossover Trials Investigating the Effects of Manual Pressure

Alberto Arribas-Romano  1   2   3 , Josué Fernández-Carnero  2   3   4   5 , Leonardo Rodríguez-Lagos  1   2 , Miguel Molina-Álvarez  2   6 , Jesús Zabala-Zambrano  4   7 , Lucas Lezaun-Hernández  4   8 , Lucía Contreras-Padilla  9   10 , Francisco Mercado  2   11
Affiliations

CPM-Related Mechanisms Could Play a Key Role in the Effects on Pain Sensitivity Induced by Manual Therapy: Three Crossover Trials Investigating the Effects of Manual Pressure

Alberto Arribas-Romano et al. J Clin Med. .

Abstract

Objective: The aim of this study is to assess whether pain-inducing manual pressure (PIMP) leads to effects on pressure pain threshold (PPT) mediated by conditioned pain modulation (CPM) and whether these effects are influenced by the intensity and repetition of the stimulus. Additionally, the influence of psychological factors and physical activity on the response to PIMP was explored. Methods: A total of 72 pain-free students were randomly assigned to three crossover trials. Trial 1 compared the effects of PIMP with the cold pressor task and pain-inducing electrostimulation. Trial 2 compared the effects of manual pressure that elicited moderate pain, mild pain, and no pain. Trial 3 compared a single PIMP stimulation with four stimuli applied at the same site or at different sites. Results: PIMP produced a lower increase in PPT than cold pressor task and no difference with electrostimulation. Manual pressure that caused moderate pain led to a greater increase in PPT compared to mild pain and pain-free application. Repetition of PIMP stimulus, whether at the same or different sites, did not significantly increase PPT compared to a single stimulation. No association with psychological factors or physical activity was found. Conclusions: PIMP produces an increase in PPT, suggesting the involvement of CPM-related mechanisms.

Keywords: conditioned pain modulation; manual therapy; pain mechanisms.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Experimental session timeline.
Figure 2
Figure 2
Participant flow diagram.
Figure 3
Figure 3
PPT before and after each of the interventions in Trial 1.
Figure 4
Figure 4
PPT before and after each of the interventions in Trial 2.
Figure 5
Figure 5
PPT before and after each of the interventions in Trial 3.
See this image and copyright information in PMC

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