Limited association between central pain processing and clinical outcomes in non-specific chronic neck pain after a manual therapy intervention: A secondary analysis

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice Pub Date : 2025-03-28 DOI:10.1016/j.msksp.2025.103323

Josu Zabala-Mata , Jon Jatsu Azkue , Joel E. Bialosky , Estíbaliz López-Dominguez , Diego Rada Fernandez de Jauregui , Ion Lascurain-Aguirrebeña

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引用次数: 0

Abstract

Background

Non-specific chronic neck pain (NSCNP) is a prevalent condition causing significant disability. While manual therapy is recommended, its clinical benefits are limited. The relationship between central pain processing and treatment outcomes in NSCNP remains unclear.

Objectives

To assess whether central pain processing measures could predict manual therapy outcomes in NSCNP patients.

Design

Pre-planned secondary analysis.

Methods

Sixty-three NSCNP patients underwent a four-week manual therapy regimen. Central pain processing mechanisms were assessed using Pressure Pain Threshold (PPT), Temporal Summation of Pain (TSP), and Conditioned Pain Modulation (CPM). Clinical outcomes were measured using the Neck Disability Index (NDI), pain intensity, and the Global Rating of Change Scale (GRoC). Univariate and multivariate regression models explored associations between baseline variables and treatment outcomes.

Results

Multivariate analysis identified baseline CPM and neck pain duration as significant predictors of treatment outcome based on GRoC. A weak negative association was found between CPM and GRoC (p < 0.05), suggesting that patients with lower CPM response reported better perceived outcomes. Baseline NDI was inversely associated with changes in disability (p < 0.01). Baseline pain intensity (p < 0.01) and duration (p < 0.05) were inversely related to pain reduction, while baseline CPM narrowly missed significance. No significant associations were found between TSP, PPT, and clinical outcomes.

Conclusion

The findings suggest a limited association between pre-treatment central pain processing status and manual therapy outcomes in NSCNP patients. The lower CPM response was modestly predictive of better outcomes, contrary to expectations. Routine use of QST measures to guide treatment decisions in this population is not supported by current data.

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来源期刊

Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

4.10

自引率

8.70%

发文量

152

审稿时长

48 days

期刊介绍： Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.