The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review

Pain Research and Treatment
Andrew D Vigotsky, Ryan P Bruhns

Abstract

Manual therapy has long been a component of physical rehabilitation programs, especially to treat those in pain. The mechanisms of manual therapy, however, are not fully understood, and it has been suggested that its pain modulatory effects are of neurophysiological origin and may be mediated by the descending modulatory circuit. Therefore, the purpose of this review is to examine the neurophysiological response to different types of manual therapy, in order to better understand the neurophysiological mechanisms behind each therapy's analgesic effects. It is concluded that different forms of manual therapy elicit analgesic effects via different mechanisms, and nearly all therapies appear to be at least partially mediated by descending modulation. Additionally, future avenues of mechanistic research pertaining to manual therapy are discussed.

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Citations

Oct 3, 2019·Journal of Sport Rehabilitation·Paula ChavesFernando Ribeiro
Jun 17, 2020·The Journal of Manual & Manipulative Therapy·Adam Wielechowski, Kyle Feldman
Apr 2, 2020·Journal of Complementary & Integrative Medicine·Shyam Jungade
Sep 27, 2018·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Ho Yong Choi, Chang-Hyun Lee
May 28, 2020·Frontiers in Neuroscience·Carla Rigo LimaWilliam Ray Reed
Dec 30, 2020·International Journal of Environmental Research and Public Health·Joanna KućMaria Gołębiewska
Nov 21, 2020·Journal of Clinical Medicine·César Fernández-de-Las-Peñas, Harry Von Piekartz
Mar 3, 2021·European Journal of Physical and Rehabilitation Medicine·Kamil Zaworski, Robert Latosiewicz
May 12, 2021·Complementary Therapies in Medicine·Siti Yuyun Rahayu FitriNenden Nur Asriyani Maryam

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