ArticleChiropractic & manual therapies2022
Pressure pain thresholds in a real-world chiropractic setting: topography, changes after treatment, and clinical relevance?
Article in Chiropractic & manual therapies, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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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.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Immediate clinical and neuromechanical effects of cervical spine manipulation compared to cervical spine mobilization among individuals with chronic neck pain: a randomized mechanistic cross-over trial.Chiropractic & manual therapies · 2026Trial
- Verbal framing, rather than measured cognitive-affective variables, is associated with short-term outcomes after spinal manipulation: a secondary analysis of a randomized controlled trial.Pain management · 2026Trial
- Association between pain sensitivity and distance from the affected level of disc herniation.Scientific reports · 2025Article
- Spinal manipulation/mobilization: past, present, future.Chiropractic & manual therapies · 2025Article
- Waste not, want not: call to action for spinal manipulative therapy researchers.Chiropractic & manual therapies · 2024Article
- A new role for spinal manual therapy and for chiropractic? Part I: weaknesses and threats.Chiropractic & manual therapies · 2024Article
- Combining Static and Dynamic Myofascial Dry Cupping Therapy to Improve Local and Regional Symptoms in Individuals with Low Back Pain: A Case Series.International journal of sports physical therapy · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChanges in pain sensitivity are a commonly suggested mechanism for the clinical effect of spinal manipulative therapy (SMT). Most research has examined pressure pain thresholds (PPT) and has primarily been conducted in controlled experimental setups and on asymptomatic populations. Many important factors are likely to differ between research and clinical settings, which may affect PPT changes following SMT. Therefore, we planned to investigate PPT before and after clinical chiropractic care and investigate relationships with various potentially clinically-relevant factors.
methodsWe recruited participants from four Danish chiropractic clinics between May and August 2021. A total of 129 participants (72% of the invited) were included. We measured PPT at eight pre-determined test sites (six spinal and two extra-spinal) immediately before (pre-session) and immediately after (post-session) the chiropractic consultation. We used regression analyses to investigate PPT changes, including the following factors: (i) vertebral distance to the nearest SMT site, (ii) rapid clinical response, (iii) baseline PPT, (iv) number of SMTs performed, (v) at the region of clinical pain compared to other regions, and (vi) if other non-SMT treatment was provided. We also performed topographic mapping of pre-session PPTs.
resultsAfter the consultation, there was a non-significant mean increase in PPT of 0.14 kg (95% CIs = - 0.01 to 0.29 kg). No significant associations were found with the distance between the PPT test site and nearest SMT site, the clinical response of participants to treatment, the pre-session PPT, the total number of SMTs performed, or the region/s of clinical pain. A small increase was observed if myofascial treatment was also provided. Topographic mapping found greater pre-session PPTs in a caudal direction, not affected by the region/s of clinical pain.
conclusionsThis study of real-world chiropractic patients failed to demonstrate a substantial local or generalized increase in PPT following a clinical encounter that included SMT. This runs counter to prior laboratory research and questions the generalizability of highly experimental setups investigating the effect of SMT on PPT to clinical practice.
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