Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation

Annina Schmid, Florian Brunner, Anthony Wright, Lucas M. Bachmann

This systematic review aims to assess the consistency of evidence supporting an involvement of supraspinal systems in mediating the effects of passive cervical joint mobilisation.  Fifteen studies met the inclusion criteria. The overall quality was high. Consistency for concurrent hypoalgesia, sympathetic nervous system excitation and changes in motor function was found. Pooling of data suggested that joint mobilisation improved outcomes by approximately 20% relative to controls. This specific pattern suggests that descending pathways might play a key role in manual therapy induced hypoalgesia.

This review supports the existence of an alternative neurophysiological model, in which passive joint mobilisation stimulates areas within the central nervous system.

Manual Therapy, 2008, 13(5), 387-396

Link to Abstract

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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