Effects of Painful Compared to Painless Manual Therapy on Pain Processing in University Students With Neck Pain

Josue Fernandez Carnero

Status: Completed

Conditions: Neck Pain

Treatments: Other: Manual Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT05680688

PAINMT1

Details and patient eligibility

About

The purpose of this study is to evaluate the effects of provoking pain with manual therapy on pain processing in university students with recurrent or chronic neck pain.

Full description

The mechanical stimulus produced in manual therapy (MT) techniques elicits neurophysiological responses within the peripheral and central nervous system responsible for pain inhibition. Almost all types of MT elicit a neurophysiological response that is associated with the descending pain modulation circuit. But it has not been demonstrated whether this inhibition occurs through a conditioned pain modulation mechanism generated by the pain that manual therapy techniques may elicit in the patient.

Enrollment: 38 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• University students
• Chronic neck pain (persistent pain > 3 months almost every day of the week) or recurrent neck pain (repeated episodes of neck pain starting > 3 months ago with pain-free periods)
• Non-specific neck pain (pain in the neck region that is not attributable to a known specific such as herniated disc, myelopathy, fractures, spinal stenosis, neoplasm etc. nor is it associated with traumatic causes such as whiplash)
• Mean NRS score the last week > 2/10 and presence of pain on the day of assesment and treatment

Exclusion criteria

• Signs of radiculopathy or neuropathic pain
• Neck surgeries
• Inflammatory rheumatic
• Neurological, cardiorespiratory, oncological or psychiatric disease
• Pregnancy
• Not being able to read Spanish in order to fill in the questionnaires

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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38 participants in 2 patient groups

Painful Manual Therapy

Experimental group

Description:

Manual therapy treatment shall be carried out at a high intensity that causes pain to the patient. The aim is to provoke a medium intensity pain to the patient of 5/10 in the NRS. The physiotherapist will ask every 30 seconds the pain provoked by the treatment with the numeric rating scale (NRS) and the patient will give continuous feedback. Based on this, the physiotherapist will adapt the intensity of the treatment to provoke a medium intensity pain.

Treatment:

Other: Manual Therapy

Painless Manual Therapy

Active Comparator group

Description:

Manual therapy treatment shall be performed at a low intensity that does not cause pain to the patient. The aim is for the patient to report a pain intensity of 0/10 in NRS throughout treatment. The physiotherapist will ask every 30 seconds the pain provoked by the treatment with NRS and the patient will give continuous feedback. Based on this, the physiotherapist will adapt the intensity of the treatment to be performed below the pain threshold.

Treatment:

Other: Manual Therapy