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Spinal Manipulation Clinically Reduces Pain Sensitivity

Spinal manipulative therapy (SMT) has been proven to provide clinically significant outcomes for patients with musculoskeletal pain and more recently, has been shown to be the most cost-effective way to manage these patients. There are two main mechanisms of action with SMT based on the portion of the nervous system that is targeted. Traditionally, there is the peripheral nervous system, which involves the spinal facet joints and intervertebral discs. Chiropractors have known for over 115 years that spinal manipulation also has effects on the central nervous system (CNS) which has a greater effect on balance, coordination and pain control. People "feel better" after treatment and until recently, there were no formal reviews of studies that actually investigated the role of SMT on pain Control at the CNS level.

Coronado et al. (2012) state, "The purpose of this systematic review is to examine the literature on the hypoalgesic effects of SMT on pain sensitivity measures and to quantify these effects using metaanalysis" (p. 1). "The mechanism of SMT remains elusive, but SMT appears to modulate pain through both central and peripheral pathways...Additionally, subgroup analysis showed a significant effect of SMT on remote sites of pressure stimulus application further supporting a potential influence on higher levels within the central nervous system" (Coronado et al., 2012, p. 14).

Being able to offer patients a cost-effective, clinically significant and safe treatment for pain control is an important part of musculoskeletal care. Narcotic pain medication and prolonged use of NSAIDs have been shown to have negative long-term effects on body Systems and their burden on society is increasing. Chiropractors are the number one providers of spinal manipulative therapy (SMT) and their training and clinical experience with this technique far exceeds other providers. Chiropractic care is a Critical component of musculoskeletal care in the United States and will continue to modulate pain, increase function and reduce Costs.


Coronado, R. A., Gay, C. W., Bialosky, J. E., Carnaby, G. D., Bishop, M.D., & George, S. Z. (2012). Changes in pain sensitivity following spinal manipulation: A Systematic review and meta-analysis. Manuscript in preparation. Retrieved from

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