Kovanur Sampath Kesava, Mani Ramakrishnan, Cotter James David, Tumilty Steve
Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand.
Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand.
Med Hypotheses. 2015 Dec;85(6):819-24. doi: 10.1016/j.mehy.2015.10.003. Epub 2015 Oct 14.
The autonomic nervous system and the hypothalamic-pituitary-adrenal axis have been shown to be dysfunctional in a number of chronic pain disorders. Spinal manipulation is a therapeutic technique used by manual therapists, which may have widespread neuro-physiological effects. The autonomic nervous system has been implicated to modulate these effects. A theory is proposed that spinal manipulation has the potential to be used as a tool in restoring the autonomic nervous system balance. Further, it is also hypothesised that through its anatomical and physiological connections, the autonomic nervous system activity following a thoracic spinal manipulation may have an effect on the hypothalamic-pituitary-adrenal axis and therefore pain and healing via modulation of endocrine and physiological processes. To substantiate our hypothesis we provide evidence from manual therapy studies, basic science and animal studies. According to the proposed theory, there will be measurable changes in the neuro-endocrinal mechanisms following a thoracic spinal manipulation. This has far-reaching implications for manual therapy practice and research and in the integration of spinal manipulation in the treatment of a wide array of disorders.
自主神经系统以及下丘脑 - 垂体 - 肾上腺轴在多种慢性疼痛疾病中已被证明存在功能障碍。脊柱推拿是手法治疗师使用的一种治疗技术，可能具有广泛的神经生理效应。自主神经系统被认为可调节这些效应。本文提出一种理论，即脊柱推拿有潜力作为恢复自主神经系统平衡的一种工具。此外，还假设通过其解剖学和生理学联系，胸椎推拿后的自主神经系统活动可能会通过调节内分泌和生理过程，对下丘脑 - 垂体 - 肾上腺轴产生影响，进而影响疼痛和愈合。为了证实我们的假设，我们提供了手法治疗研究、基础科学和动物研究的证据。根据所提出的理论，胸椎推拿后神经内分泌机制将会出现可测量的变化。这对手法治疗实践和研究以及脊柱推拿在多种疾病治疗中的整合具有深远意义。
