Influence of Manipulation in the Peripheral Nervous System Tests: A Randomized Controlled Trial

Background: Chronic cervical pain is a serious public health issue that affects a large part of the world population and results in huge costs for the society. The chronic cervical pain is associated to problems in the peripheral nervous system. Clinical practice presents multiple techniques conventionally used to ameliorate chronic cervical pain. The spinal manipulation is a technique that can increase the range of motion of the peripheral nervous system. Objective: To determine the efficacy of the cervical and thoracic manipulation in the peripheral nervous system tests. Methods: The present study is a randomized controlled trial, with blinded assessor. The patient population consisted of 128 patients with chronic cervical pain and also tested positive (pain in motion) to the neural system. They were randomly divided into four groups: group A (ma- nipulation of the sixth cervical vertebra), group B (manipulaton of the sixth thoracic vertebra), group C (manipulation of the sixth cervical and sixth thoracic vertebra) and group D (without intervention). These patients underwent an assessment before and after spinal manipulation by the blinded assessor. Results: After the manipulation, an improvement of the ragion of motion was observed on the group that the sixth cervical vertebra was handled: left median nerve range of motion (p=0.04) and right (p=0.04) and left ulnar nerve (p=0.03) and right (p=0.04). Also was observed a sta- tistically significant result when associate manipulation of the sixth cervical vertebra and sixth thoracic vertebra: left median nerve (p=0.01) and the right side (p=0.03). Conclusion: Isolated manipulation of the sixth cervical vertebra or together with the manipula- tion of the sixth thoracic vertebra in individuals with chronic neck pain appears to be an ef- fective resource in improving range of motion in patients that tested positive to the peripheral nervous system tests.