Conditioned pain modulation elicited through manual pressure techniques on the cervical spine: a crossover study

Abstract. Introduction:. Manual pressure techniques are commonly employed as a therapeutic approach for individuals experiencing musculoskeletal pain. The painful nature of these techniques suggests that a central mechanism known as conditioned pain modulation (CPM) might play a role. Objectives:. T...

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Main Authors: René Castien, Roland R. Reezigt, Ruben den Hartog, Andreas Amons, Willem De Hertogh, Gwendolyne G. Scholten-Peeters
Format: Article
Language:English
Published: Wolters Kluwer 2025-04-01
Series:PAIN Reports
Online Access:http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001258
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author René Castien
Roland R. Reezigt
Ruben den Hartog
Andreas Amons
Willem De Hertogh
Gwendolyne G. Scholten-Peeters
author_facet René Castien
Roland R. Reezigt
Ruben den Hartog
Andreas Amons
Willem De Hertogh
Gwendolyne G. Scholten-Peeters
author_sort René Castien
collection DOAJ
description Abstract. Introduction:. Manual pressure techniques are commonly employed as a therapeutic approach for individuals experiencing musculoskeletal pain. The painful nature of these techniques suggests that a central mechanism known as conditioned pain modulation (CPM) might play a role. Objectives:. This study tested whether a painful manual pressure technique (MPT) reduces pain sensitivity partly by eliciting a CPM effect. Methods:. This crossover study examined 3 different conditioning stimuli: (1) a cold pressor test (CPT) with the contralateral hand submerged in a cold water bath, (2) painful MPT, and (3) sham-MPT on suboccipital muscles. We measured their effect on pain sensitivity using pressure pain thresholds at 3 locations: locally (suboccipital muscles), regionally (trapezius muscle), and remotely (tibialis anterior muscle). Results:. In 63 healthy participants, no significant differences were found between the painful MPT and CPT on the pressure pain thresholds at all test locations: locally, −11 kPa (95% CI: 3 to −25); regionally, −15 kPa (95% CI: 10 to −39); and remotely, −24 kPa (95% CI: 55 to −7). Manual pressure technique compared to sham-MPT showed significant differences in the suboccipital muscles, −20.04 kPa (95% CI: −6.45 to −34.63) and the trapezius muscle, −38.24 (95% CI: −13.97 to −62.5) but no significant difference at the tibialis anterior muscle, −17.5 kPa (95% CI: 13.9 to −48.91). Conclusion:. Painful MPTs applied at the suboccipital muscles reduce pain sensitivity at all sites, similar to the CPT, indicating CPM activation. Central pain inhibition might contribute to the effect of painful MPT in healthy people.
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spelling doaj-art-b27cae8bf0654cfbad959b3e6b03430c2025-08-20T02:40:51ZengWolters KluwerPAIN Reports2471-25312025-04-01102e125810.1097/PR9.0000000000001258PR90000000000001258Conditioned pain modulation elicited through manual pressure techniques on the cervical spine: a crossover studyRené Castien0Roland R. Reezigt1Ruben den Hartog2Andreas Amons3Willem De Hertogh4Gwendolyne G. Scholten-Peeters5a Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlandsa Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlandsa Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlandsb Amsterdam Public Health Research Institute, Department of General Practice, Section Research—Soma & Psyche, Vrije Universiteit Amsterdam, Amsterdam, the Netherlandse Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgiuma Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, the NetherlandsAbstract. Introduction:. Manual pressure techniques are commonly employed as a therapeutic approach for individuals experiencing musculoskeletal pain. The painful nature of these techniques suggests that a central mechanism known as conditioned pain modulation (CPM) might play a role. Objectives:. This study tested whether a painful manual pressure technique (MPT) reduces pain sensitivity partly by eliciting a CPM effect. Methods:. This crossover study examined 3 different conditioning stimuli: (1) a cold pressor test (CPT) with the contralateral hand submerged in a cold water bath, (2) painful MPT, and (3) sham-MPT on suboccipital muscles. We measured their effect on pain sensitivity using pressure pain thresholds at 3 locations: locally (suboccipital muscles), regionally (trapezius muscle), and remotely (tibialis anterior muscle). Results:. In 63 healthy participants, no significant differences were found between the painful MPT and CPT on the pressure pain thresholds at all test locations: locally, −11 kPa (95% CI: 3 to −25); regionally, −15 kPa (95% CI: 10 to −39); and remotely, −24 kPa (95% CI: 55 to −7). Manual pressure technique compared to sham-MPT showed significant differences in the suboccipital muscles, −20.04 kPa (95% CI: −6.45 to −34.63) and the trapezius muscle, −38.24 (95% CI: −13.97 to −62.5) but no significant difference at the tibialis anterior muscle, −17.5 kPa (95% CI: 13.9 to −48.91). Conclusion:. Painful MPTs applied at the suboccipital muscles reduce pain sensitivity at all sites, similar to the CPT, indicating CPM activation. Central pain inhibition might contribute to the effect of painful MPT in healthy people.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001258
spellingShingle René Castien
Roland R. Reezigt
Ruben den Hartog
Andreas Amons
Willem De Hertogh
Gwendolyne G. Scholten-Peeters
Conditioned pain modulation elicited through manual pressure techniques on the cervical spine: a crossover study
PAIN Reports
title Conditioned pain modulation elicited through manual pressure techniques on the cervical spine: a crossover study
title_full Conditioned pain modulation elicited through manual pressure techniques on the cervical spine: a crossover study
title_fullStr Conditioned pain modulation elicited through manual pressure techniques on the cervical spine: a crossover study
title_full_unstemmed Conditioned pain modulation elicited through manual pressure techniques on the cervical spine: a crossover study
title_short Conditioned pain modulation elicited through manual pressure techniques on the cervical spine: a crossover study
title_sort conditioned pain modulation elicited through manual pressure techniques on the cervical spine a crossover study
url http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001258
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