Using fMRI to Determine if Cerebral Hemodynamic Responses to Pain Change Following Thoracic Spine Manipulation in Individuals With Mechanical Neck Pain
| Status: | Recruiting |
|---|---|
| Conditions: | Orthopedic, Pain |
| Therapuetic Areas: | Musculoskeletal, Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - 60 |
| Updated: | 4/13/2015 |
| Start Date: | May 2013 |
| Contact: | Cheryl L Sparks, PhD |
| Email: | csparks@bradley.edu |
| Phone: | 3096774533 |
Thoracic spine thrust manipulation (TSM) has been shown to be an effective intervention in
the management of patients with neck pain. However the mechanisms for pain relief
associated with this intervention remain largely unexplained. Recent evidence suggests
structures within the brain may have a role in creating responses of pain relief. This
study aims to use functional magnetic resonance imaging (fMRI) to determine if there is a
change in blood flow to structures within the brain following TSM in patients with neck
pain. All patients will undergo fMRI while receiving painful stimuli directed to two
separate sites, the cuticle of the index finger and the great toe. Subjects will then
receive either TSM or sham-manipulation and then immediately undergo a second fMRI scan
receiving the same painful stimuli. The primary outcome of interest is the shift in blood
flow within the brain before and after TSM or sham manipulation as measured by Blood Oxygen
Level Dependent (BOLD) technology. This study will be the first to examine this type of
response to manual therapy within the brain in patients with neck pain.
the management of patients with neck pain. However the mechanisms for pain relief
associated with this intervention remain largely unexplained. Recent evidence suggests
structures within the brain may have a role in creating responses of pain relief. This
study aims to use functional magnetic resonance imaging (fMRI) to determine if there is a
change in blood flow to structures within the brain following TSM in patients with neck
pain. All patients will undergo fMRI while receiving painful stimuli directed to two
separate sites, the cuticle of the index finger and the great toe. Subjects will then
receive either TSM or sham-manipulation and then immediately undergo a second fMRI scan
receiving the same painful stimuli. The primary outcome of interest is the shift in blood
flow within the brain before and after TSM or sham manipulation as measured by Blood Oxygen
Level Dependent (BOLD) technology. This study will be the first to examine this type of
response to manual therapy within the brain in patients with neck pain.
Inclusion Criteria:
- Primary complaint of mechanical neck pain of less than 6 weeks in duration as
identified in the patient's initial physical examination. Mechanical neck pain is
defined as generalized neck and/or shoulder, peri-scapular pain with symptoms
provoked by neck postures, neck movements, or palpation of the cervical musculature
Exclusion Criteria:
- Any medical red flags suggestive of non-musculoskeletal origin of pain, such as
metabolic disorders, osteoporosis, tumor, and/or rheumatoid arthritis
- No contraindications to spinal mobilization
- No contraindications to MRI (claustrophobia, presence of cardiac pacemakers, cochlear
implants, metal implants, implanted hearing aids, and previous injuries caused by
bullets or shrapnel, pregnancy or thought to be pregnant
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OSF St. Francis Medical Center OSF Saint Francis Medical Center, licensed for 616 beds and...
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