Changes in biochemical markers of pain perception and stress response after spinal manipulation.
METHODS
Controlled, repeated-measures, single-blind randomized study.


OBJECTIVE
To determine the effect of cervical or thoracic manipulation on neurotensin, oxytocin, orexin A, and cortisol levels.


BACKGROUND
Previous studies have researched the effect of spinal manipulation on pain modulation and/or range of movement. However, there is little knowledge of the biochemical process that supports the antinociceptive effect of spinal manipulation.


METHODS
Thirty asymptomatic subjects were randomly divided into 3 groups: cervical manipulation (n = 10), thoracic manipulation (n = 10), and nonmanipulation (control) (n = 10). Blood samples were extracted before, immediately after, and 2 hours after each intervention. Neurotensin, oxytocin, and orexin A were determined in plasma using enzyme-linked immuno assay. Cortisol was measured by microparticulate enzyme immuno assay in serum samples.


RESULTS
Immediately after the intervention, significantly higher values of neurotensin (P<.05) and oxytocin (P<.001) levels were observed with both cervical and thoracic manipulation, whereas cortisol concentration was increased only in the cervical manipulation group (P<.05). No changes were detected for orexin A levels. Two hours after the intervention, no significant differences were observed in between-group analysis.


CONCLUSIONS
The mechanical stimulus provided by spinal manipulation triggers an increase in neurotensin, oxytocin, and cortisol blood levels. Data suggest that the initial capability of the tissues to tolerate mechanical deformation affects the capacity of these tissues to produce an induction of neuropeptide expression. J
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
Gustavo
G
Plaza-Manzano
Francisco
F
Molina-Ortega
Rafael
R
Lomas-Vega
Antonio
A
Martínez-Amat
Alexander
A
Achalandabaso
Fidel
F
Hita-Contreras
D000328:Adult; D058070:Asymptomatic Diseases / Q000628:therapy; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D047908:Intracellular Signaling Peptides and Proteins / Q000097:blood; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods; D019547:Neck Pain / Q000097:blood / Q000628:therapy*; D009479:Neuropeptides / Q000097:blood; D009496:Neurotensin / Q000097:blood; D000068797:Orexins; D010121:Oxytocin / Q000097:blood; D058748:Pain Perception / Q000502:physiology*; D016037:Single-Blind Method; D055815:Young Adult
D015415:Biomarkers; C000596229:HCRT protein, human; D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D000068797:Orexins; D009496:Neurotensin; D010121:Oxytocin; D006854:Hydrocortisone