W2 PRINCIPLES

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Neurophysiologic effects of the spinal adjustment

Last updated 1:49 AM on 9/14/26
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1
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Explain why spinal manipulation plays an important role in pain and inflammatory disorders

  • Changes in biochemical markers such as substance-P, neurotensin, interleukins and cortisol which all help to modulate pain and inflammation

  • Spinal manipulation increases substance-P, neurotensin, oxytocin, altering these various biochemical markers


2
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Explain the injury mechanism, and how the adjustment can modulate this.

  • Person stubs toe→ peripheral sensitisation

  • Cell damage occurs, leading to an ‘inflammatory soup’ of bradykinin prostaglandins and serotonin

  • Message travels along peripheral nerve to dorsal horn for modulation

  • Message then travels up the spinal cord, where pain is perceived

  • Adjustment activates descending pathway from the brainstem, which in turn activates neurotransmitters that have an inhibitory effect at the dorsal horn

  • This is known as a supraspinal mediated mechanism


<ul><li><p>Person stubs toe→ peripheral sensitisation</p></li><li><p>Cell damage occurs, leading to an ‘inflammatory soup’ of bradykinin prostaglandins and serotonin</p></li><li><p>Message travels along peripheral nerve to dorsal horn for modulation</p></li><li><p>Message then travels up the spinal cord, where pain is perceived</p></li><li><p>Adjustment activates descending pathway from the brainstem, which in turn activates neurotransmitters that have an inhibitory effect at the dorsal horn</p></li><li><p>This is known as a supraspinal mediated mechanism</p></li></ul><p></p>
3
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What are the two types of summation?

Spatial summation and temporal summation


4
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Describe spatial summation

  1. Simultaneous stimulation by several presynaptic neurons

  2. EPSPs spread from several synapses to axon hillock

  3. Postsynaptic neuron fires


<ol><li><p>Simultaneous stimulation by several presynaptic neurons</p></li><li><p>EPSPs spread from several synapses to axon hillock</p></li><li><p>Postsynaptic neuron fires</p></li></ol><p></p>
5
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Describe temporal summation

  1. High frequency stimulation by one presynaptic neuron

  2. EPSPs spread from one synapse to axon hillock

  3. Post synaptic neuron fires


  • In this process, only one presynaptic neuron is triggered repeatedly over a period of time

  • If the signal reaches the threshold (depolarisation), then there is firing of the postsynaptic neuron


<ol><li><p>High frequency stimulation by one presynaptic neuron</p></li><li><p>EPSPs spread from one synapse to axon hillock</p></li><li><p>Post synaptic neuron fires</p></li></ol><p></p><ul><li><p>In this process, only one presynaptic neuron is triggered repeatedly over a period of time</p></li><li><p>If the signal reaches the threshold (depolarisation), then there is firing of the postsynaptic neuron</p></li></ul><p></p>
6
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What does spinal manipulation do to temporal summation that light mechanical touch cannot?

Induces inhibition, which creates hypoalgesia

7
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How are the clinical effects associated with spinal manipulative therapy believed to be explained?

  • By the vertebral displacement and muscle response generated during the procedure

  • This can be of short or long impulse duration (spinal manipulation, spinal mobilisation)


8
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What neuromechanical responses can be created by spinal manipulation?

  • Greater intervertebral movement than mobilisation (long impulse duration)

  • Muscle response of greater amplitude than mobilisation