Short-Term Effects of Manipulation to the Upper Thoracic Spine of Asymptomatic Subjects on Plasma Concentrations of Epinephrine and Norepinephrine—A Randomized and Controlled Observational Study

• Published in: Journal of manipulative and physiological therapeutics Vol. 35; no. 3; pp. 209 - 215
• Main Authors: Puhl, Aaron A., MSc, Injeyan, H. Stephen, MSc, PhD, DC
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.03.2012
• Subjects: Adult; Age Factors; Autonomic Nervous System; Enzyme-Linked Immunosorbent Assay; Epinephrine; Epinephrine - blood; Female; Humans; Male; Manipulation, Spinal - methods; Middle Aged; Musculoskeletal Manipulations; Norepinephrine; Norepinephrine - blood; Ontario; Physical Medicine and Rehabilitation; Prospective Studies; Reference Values; Sex Factors; Single-Blind Method; Thoracic Vertebrae; Time Factors; Young Adult; Ontario; Epinephrine; Autonomic Nervous System; Musculoskeletal Manipulations; Norepinephrine
• ISSN: 0161-4754; 1532-6586
• DOI: 10.1016/j.jmpt.2012.01.012

Abstract Objective The purpose of this study was to investigate the short-term effects of spinal manipulation applied to a hypomobile segment of the upper thoracic spine (T1-T6), on plasma concentrations of norepinephrine (NE) and epinephrine (E) in asymptomatic subjects, under strictly controlled conditions. Methods Fifty-six asymptomatic subjects were randomly assigned to receive either a chiropractic manipulative intervention or a sham intervention in the upper thoracic spine. A 20-gauge catheter fitted with a saline lock was used to sample blood before, immediately after, and 15 minutes after intervention. Plasma NE and E concentrations were determined using an enzyme-linked immunosorbent assay. Changes in plasma catecholamine concentrations were analyzed within and between groups using 1- and 2-sample t tests, respectively. Results The plasma samples of 36 subjects (18 treatment, 18 control) were used in the analysis. Mean plasma concentrations of NE and E did not significantly differ between the 2 groups at any time point and did not change significantly after either the manipulative or sham intervention. Conclusions The results of this study indicate that a manipulative thrust directed to a hypomobile segment in the upper thoracic spine of asymptomatic subjects does not have a measurable effect on the plasma concentrations of NE or E. These results provide a baseline measure of the sympathetic response to spinal manipulation.