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

Conditioned Pain Modulation Effects of Manual Therapy in University Students With Recurrent or Chronic Neck Pain

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.

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.

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