Trial reportChiropractic & manual therapies2021
Spinal manipulation and modulation of pain sensitivity in persistent low back pain: a secondary cluster analysis of a randomized trial.
Trial report in Chiropractic & manual therapies, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04086667 (What Determines a Positive Outcome of Spinal Manipulation for Persistent Low Back Pain), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
What Determines a Positive Outcome of Spinal Manipulation for Persistent Low Back Pain: Stiffness or Pain Sensitivity? A Randomized Trial
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Baseline individual factors associated with clinical outcomes in adults with non-specific low back pain following manual therapy: a systematic review.BMC complementary medicine and therapies · 2025Pooled it
- The role of biopsychosocial factors in classifying pain intensity across various chronic pain conditions.Scientific reports · 2026Article
- Spine-Prints: Transposing Brain Fingerprints to the Spinal Cord.bioRxiv : the preprint server for biology · 2025Article
- The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews.PloS one · 2025Article
- Quantitative sensory testing in dogs with spontaneous osteoarthritis.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Sensory phenotypes in complex regional pain syndrome and chronic low back pain-indication of common underlying pathomechanisms.Pain reports · 2023Article
- The Neurophysiological Lesion: A Scoping Review.Journal of chiropractic medicine · 2023Article
- Article
- Pressure pain thresholds in a real-world chiropractic setting: topography, changes after treatment, and clinical relevance?Chiropractic & manual therapies · 2022Article
- Nonoperative treatment for pain sensitization in patients with low back pain: protocol for a systematic review.Systematic reviews · 2022Article
- Time to evolve: the applicability of pain phenotyping in manual therapy.The Journal of manual & manipulative therapy · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundPain hypersensitivity can be assessed using Quantitative Sensory Testing (QST) and is associated with persistent low back pain. Spinal manipulation appears to modify pain hypersensitivity, and this could function as one mechanism leading to clinical improvements. In the current study, we applied a comprehensive QST battery to assess pain sensitivity in a cohort of low back pain patients before and after spinal manipulation to improve our understanding of the association between QST and clinical improvements. This study addresses two questions: Are clinical improvements following spinal manipulation in low back pain patients contingent on pain hypersensitivity, and does pain sensitivity change following spinal manipulation?
methodsWe performed a secondary analysis of data from a randomized clinical trial. One hundred and thirty-two participants with persistent LBP were treated with spinal manipulation four times over two weeks. Patient-reported outcomes and QST were assessed at baseline, after the fourth spinal manipulation session, and 14-days later. The clinical outcomes were changes in low back pain intensity and disability. Using latent profile analysis, we categorized the participants into clusters depending on their baseline QST scores. We used linear mixed models to examine the association between clusters and changes in patient-reported outcomes and QST.
resultsTwo clusters emerged: a Sensitized and a Not sensitized. The former had significantly lower regional pressure and thermal pain thresholds, remote pressure pain tolerance, and lower inhibitory conditioned pain modulation than the Not sensitized group. However, we only found between-cluster differences for regional pressure pain threshold following spinal manipulation. Thus, the clusters were not associated with patient-reported pain and disability changes or the remaining QST outcomes.
conclusionsWe report that the baseline QST profile was not associated with clinical improvements following spinal manipulation. We did observe a substantial change for regional pressure pain threshold, which suggests that any effect of spinal manipulation on pain sensitivity is most likely to be observed as changes in regional, mechanical pain threshold. However, the mechanism that invokes clinical improvement and pain sensitivity changes appear distinct. Due to methodological caveats, we advise caution when interpreting the results.
trial registrationClinical.Trial.gov identifier: NCT04086667 , registered 11 September 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04086667.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.