37 Pain (Pain inhibition in manual therapy)

Question 1

What are the central and local mechanisms explaining pain relief in manual therapy?

Answer 1

Central mechanisms:
pain modulation at dorsal horn (gate control theory)
and activation of central inhibitory pathways

local tissue changes:
fluid drainage clears pain causing metabolites and decreases pressure on local nociceptors, and may relieve mechanical causes of pain

Question 2

what is the gate control theory?

Answer 2

modulation of pain at dorsal horn of spinal cord

non-nociceptive afferent neurons close the ‘gate’ (inhibitory interneurons) at the dorsal horn of the spinal cords

blocks nociceptive signals from ascending to the brain

Question 3

what are central inhibitory pathways?

Answer 3

pain inhibiting descending pathways

originate in somatosensory cortex and hypothalamus in brain

release inhibitory neurotransmitters that block the transmission of pain impulses

Question 4

what inhibitory neurotransmitters are released by central inhibitory pathways?

Answer 4

endogenous opiods
seratonin
oxytocin

Question 5

what is analgesia?

Answer 5

pain relief