Neuroendocrine Changes in Cervical Spinal Manipulation and Mobilization Non-specific Mechanical Neck Pain
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      The aim for this graduate student research project is to determine if cervical spinal
      mobilization releases similar neuropeptides and endogenous hormones as compared to cervical
      spinal manipulation and a control group. We hypothesized that application of cervical
      manipulations would result in a neuroendocrine response (SNS- HPA axis). By measuring
      salivary cortisol, oxytocin and DHEA, it may be possible to provide important information
      regarding the mechanisms and associations of pain modulation, anti-inflammatory and tissue
      healing after a biomechanical event.
    

Detailed description: 
      -  Participants will be completing three standardized questionnaires: The Neck Disability
           Index (NDI), Numeric Pain Rate Scale (NPRS), and the Global Ration of Change (GROC).
           These self-rated questionnaires will be used to capture the patient's level of pain,
           assess disability, and to quantify patient's improvement or deterioration over time,
           usually to either determine the effect of an intervention or to chart the clinical
           course of a condition.

        -  Participants will be providing four saliva samples: Collecting biomarkers in saliva
           requires reliable, accurate methods for proper storage and handling techniques with
           high-quality assays and validated testing protocols. For this study, salivary oxytocin,
           cortisol and dehydroepiandrosterone (DHEA) will be collected in the morning (between 8
           am and 11 am) for each participant at preintervention (baseline), and 15, 30 and 60
           minutes after intervention by using self-collection kits in accordance with the
           manufacturer's instructions for each biomarker (Salimetrics Inc).

        -  Participants will be receiving skilled interventions: Participants will be randomly
           assigned by using a computer-generated randomized table of numbers created prior to the
           start of data collection to one of the following three groups: cervical manipulation
           group, cervical mobilization group, no-touch group which will be receiving postural
           education. Cervical Spinal Manipulation (CSM) and Cervical Spinal Mobilizations (CSMob)
           are common techniques utilized by healthcare professionals to treat neck pain, low back
           pain and its effectiveness to treat musculoskeletal pain.
    

Intervention name(s): cervical spinal manipulation; cervical spinal mobilization
Intervention type(s): Other; Other
Intervention description(s): High-velocity, mid-range, low amplitude force at the segment of pain and/or segmental restriction. The participant will lay comfortably in a supine position, the practitioner will then use his clinical discretion to select the most appropriate or symptomatic cervical motion segments and attempt to localize the manual thrust at those levels. A maximum of 2 attempts for each side of the cervical spine will be allowed regardless of the having achieved joint cavitation.; Participant will lay comfortably in a prone position, the practitioner will then use his clinical discretion to select the most appropriate or symptomatic cervical motion segments and attempt to localize the manual forces at those segments.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other