The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia

Pain. 1996 Nov;68(1):69-74. doi: 10.1016/S0304-3959(96)03221-6.


Manipulative therapy is frequently used in the management of musculoskeletal pain. A frequently reported clinical feature of this treatment is the immediacy with which it appears to initiate improvement in pain and function. A randomised, double blind, placebo controlled, repeated measures design was employed to study the initial effects of a cervical spine treatment technique in a group of 15 patients with lateral epicondylalgia. Pressure pain threshold, pain-free grip strength, upper limb neurodynamics, pain and function were assessed prior to and following application of either a treatment, placebo or control condition. All subjects received all three conditions. Differences between the pre-post measures were used as indicators of change in subject's symptom profiles. The treatment condition produced significant improvement in pressure pain threshold, pain-free grip strength, neurodynamics and pain scores relative to placebo and control conditions (P < 0.05). In summary, this study demonstrates that manipulative therapy is capable of eliciting a rapid hypoalgesic effect.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cervical Vertebrae*
  • Double-Blind Method
  • Humans
  • Manipulation, Orthopedic*
  • Middle Aged
  • Pain / etiology
  • Pain Management*
  • Pain Threshold
  • Physical Therapy Modalities*
  • Tennis Elbow / complications*