Effects of Spinal Manipulation on Biochemical Markers in Humans

How spinal manipulation works is an interesting topic, so much so that myself and Dr. Simon Wang from CMCC created a 5-hour E-Seminar on the topic (check in out here)…

This week, an update to a previous systematic review on the changes in biochemical markers following spinal manipulation…

Although spinal manipulation (SM) is mainly used to reduce spinal pain and disability, other theories exist on the mechanisms of the therapeutic effects of SM. One theory is the biomechanical model which maintains that SM can cause changes in the biomechanics of the spine leading to its improved function. Another theory is the neurophysiological model which suggests that mechanical input, for instance SM, can trigger spinal and supraspinal neurophysiological responses.

Complex neural interactions are involved in the modulation of pain following SM which occur between various physiological systems and encompass several biochemical mediators. For instance, substance-P (SP), neurotensin, oxytocin and orexin-A have widespread pain modulation effects in the nervous system.

Previous studies have shown that SM has an influence on biochemical markers such as SP, neurotensin, oxytocin, and hormones such as cortisol. The authors of this current review previously conducted a systematic review which reported moderate level evidence that SM may influence various biochemical markers (NOTE: I posted a review in 2018 of their original systematic review on this topic that was published in late 2017 – the review title is “Changes in Biochemical Markers Following Spinal Manipulation”). However, several new studies have been published since the publication of their previous review*, prompting them to conduct and publish an update.

The aim of this current systematic review was to provide and update on: 1) the effects of SM on biochemical markers in humans and 2) determine the level of evidence for changes in biochemical biomarkers following SM.

Note from Dr. Thistle:

This line of work is evolving but remains incomplete. This doesn’t change the fact that we see patients in practice who just feel better, both immediately after SM and over time. As this research progresses, we still need to elucidate the relevant mechanisms involved in patient responses. Unfortunately, many of these studies still look at measurement of biochemical markers after only ONE treatment. It would be great to have longer term studies on patients who receive multiple SM interventions over time.

This week’s Research Review: “Effects of Spinal Manipulation on Biochemical Markers in Humans”

This paper was published in the Journal of Manual & Manipulative Therapy (2024)

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