Neuro scientific Concomitants Of Traction Decompression

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Radiological, Neuroscientific and Biomechanical

of

Cervical Traction and Lumbar Decompre

A review of The Literature Review.

Tariq J. FaridiEditor In Chief

American Journal of Spinovisceral Neuro-B

(AJSN in formation)

Visceral Somatic

Bimechanical Spinal Renal Hepato al Ca

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The brain's neural processing has been likened to a symphony or

(Goldstein JA 2004). A type of resonance termed 'neural synchro

arousal, attentional selection, and working memory. Grossberg

relationship between matching top-down expectations with botto

which focuses attention on those features of the bottom-up input

interaction of attention-learning and orienting-search subsystems an

been developed into adaptive resonance theory (ART). If there i

generalisation then amplified representation can, in turn, attentiona

representations of irrelevant sensory events (Goldstein JA 2004). T

may represent a disturbance to CNS data processing and appr

represent the attentional block which can help re-establish neural syn

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Amazingly, a decade after the realisation that immediate

neurological signs and symptoms can occur if the appropriate

applied, the research evidence still doesn't justifyPDFC




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Notethatthesinuver

tebralnerveisap

eripheralnerve.



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Through the normalisation of muscle spasm, the amount of'f

the spine should reduce. Consequently, such a reduction in m

reduce compressive forces on the intervertebral discs and b

intervertebral foramen as well as the spinal canal (Batson'

Normalisation of pressure around the dorsal root ganglion (D

the propagation of ectopic impulses to the spinal cord and m

afferent-efferent interaction in the periphery. The latter w

modulation of blood flow as well as the modulation of neurog

should be remembered that the sinuvertebral nerve is a p

responsible for these effects within the intervertebral forame

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Sympathetic-sensory coupling after L5 spinal nerve lesion in t

to changes in dorsal root ganglion blood flo

H. -J. Haebler, S. Eschenfelder, X. -G. Liu and W

Physiologisches Institut, Christian-Albrechts-Universitt, O

24098 Kiel, Germany

Received 6 December 1999; revised 2 March 2000; accepte

Available online 9 October 2000.

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Abstract

Transection of the L5 spinal nerve in rats results in allodynia-

like behavior to mechanical stimulation which are thought to b

ectopic activity arising in lesioned afferent neurons mainly in

ganglion (DRG). It has been suggested that the neuropathic pa

dependent on the sympathetic nervous system. In rats 356 da

nerve lesion, we tested responses of axotomized afferent fiber

dorsal root of the lesioned segment to norepinephrine (NE, 0.5

intravenously and to selective electrical stimulation of the lum

trunk (LST). In some experiments we measured blood flow in

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( -NAME) applied systemically. -NAME enhanced baseline

in the DRG about threefold and also increased stimulation-ind

vasoconstrictions. After -NAME, the majority of axotomized

spontaneous activity were activated by LST stimulation (76%

activations closely followed stimulation-induced phasic vasoc

DRG provided that a critical level of vasoconstriction was exc

study, inhibitory responses to LST stimulation were generally

reversed to activation by prolonged stimulation or after -NAM

show that sympathetic-sensory coupling occurs only in a mino

afferents after L5 spinal nerve injury. Like previous studies, th

notion that the L5 spinal nerve lesion is a good model for sym

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maintained pain. Since responses of lesioned afferent neurons

and NE could be provoked with high reliability after inducing

the DRG, and since they mirrored stimulation-induced vasoco

DRG, it appears that in this model the association of sympathe

afferent discharge occurs mainly when perfusion of the DRG i

Author Keywords: Neuropathic pain; L5 spinal nerve injury;

maintained pain; Dorsal root ganglion; Neurogenic vasoconstr

nervous system If one considers the sinuvertebral nerve to be

then inudction of inflammation around the DRG can in turn cr

the DRG which leads to hyperalgesia. Clearly a viscious cycle

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Induction of high mobility group box-1 in dorsal root gan

pain hypersensitivity after peripheral nerv

Pain, Volume 149, Issue 3, Pages 514-521 (June 2

Masayuki Shibasaki1, Mika Sasaki1, Mayumi Miura1, Keiko Mizu

Satoru Hashimoto, Yoshifumi Tanaka, Fumimasa AmayaCorr

Information1email address

Received 3 June 2009; received in revised form 21 January 2010; a

published online 14 April 2010.

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Abstract

Pro-inflammatory cytokine high mobility group box-1 (HMGB

inflammation in the central nervous system, but less is known

effects in the peripheral nervous system. In the present study,

in the primary afferent nerve was investigated in the context o

pathophysiology of peripheral nerve injury-induced pain hype

time PCR confirmed an increase in HMGB-1 mRNA expressi

ganglion (DRG) and spinal nerve at 1day after spinal nerve lig

Induction of HMGB-1 mRNA was observed in both injured L

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Immunohistochemistry for HMGB-1 revealed that SNL-induced H

the primary afferent neurons and satellite glial cells (SGCs) in the

cells in the spinal nerve. Up-regulation of HMGB-1 was associated

signal from the nucleus to the cytoplasm. Injection of HMGB-1

produces transient behavioural hyperalgesia. Neutralizing antib

successfully alleviated the mechanical allodynia observed after SN

for advanced glycation end products (RAGE), one of the major r

was expressed in the primary afferent neurons and SGCs in the

Schwann cells in the spinal nerve. These results indicate that HMG

secreted into the DRG and spinal nerve, and contributes to the deve

pain after nerve injury. Blocking HMGB-1/RAGE signalling migh

therapeutic strategy for the management of neuropathic pain.

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Conditioned stimulus and unconditioned stimulus inputs conv

cells in the lateral amygdala, which is the principal output nuc

projects to areas of the hypothalamus and brainstem that contr

endocrine, and autonomic conditional responses associated wi

(Goldstein JA 2004). In neurosomatic disorders, an accentuati

weighting is given to elements of a stimulus that, in actuality,

relationship to the state of activation of the long-term memory

individual with a normally functioning neural network for asso

activated memory store to which the stimulus is associated do

but continues to be highly weighted, even if this weighting is o

individual's attention (Newport DJ, Nemeroff CV 2000; in G

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Attentional resources are allocated in favour of unexpected sa

term 'switching' is used to denote reallocation processes, and '

refer to stimuli with special biological significance. Dopamine

involved in 'behavioural orienting', the allocation of attention

stimulus. This response normally extinguishes rapidly. Unexp

punishments lead to the acquisition of new conditioned respon

activity is suppressed when expected rewards fail to materializ

have evolved to resolve conflicts of multiple subsystems comp

limited motor or cognitive resources. The frontal eye fields bri

into the most active perceptual area of the retina, so it's potent

significance can be determined. The computations of the possi

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before the behavioural switch occurs, and a signal is often lost

of the stimulus is fully known (Goldstein JA 2004).

The prefrontal cortex (PFC) and noradrenergic systems are bo

attentional regulation. Lesions of the PFC impair the ability to

relevant information and to inhibit processing of irrelevant stim

locus coereleus (LC) fire in relation to the attentional state, an

the few high-order inputs to the LC and is an important regula

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Noradrenaline is known to enhance signal-to-noise ratio in sen

insufficient noradrenergic stimulation, small signals may be ob

while potent stimuli may be processed (distractors). If noradre

hypersecreted, it would take the PFC 'off line'. The PFC may b

exploratory responses in a fear-inducing environment (Goldste

Therefore, higher centres are most probably involved in assess

during the assessment of signs and symptoms.

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PlaceboversusNoceboeffect



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Mechanisms of placebo analgesia: rACC recruitment of a subcortical a

U. Bingel a, b,, J. Lorenz c, E. Schoell a, C. Weiller

Abstract

Placebo analgesia is one of the most striking examples of the cognitive mod

and the underlying mechanisms are finally beginning to be un

pharmacological studies, the endogenous opioid system is essential for p

functional imaging data provides evidence that the rostral anterior cingulate

a crucial cortical area for this type of endogenous pain control. We th

placebo analgesia recruits other brain areas outside the rACC and that inter

these brain areas mediate opioid-dependent endogenous antinociception

mechanism. Nineteen healthy subjects received and rated painful laser stimhands, one of them treated with a fake analgesic cream (placebo). Painful

by an auditory cue, indicating the side of the next laser stimulation. BOLD

laser-stimulation during the placebo and no-placebo condition were ass

fMRI. After having confirmed placebo related activity in the rACC, a conne

placebo dependent contributions of rACC activity with bilateral amygdal

gray (PAG). This finding supports the view that placebo analgesia d

functional connectivity of the rACC with subcortical brain structures that alearning and descending inhibition of nociception.

Link to Pain Journal : Volume 120, Issues 1-2 , January 2006, Pages 8-15

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Multimodal approach to treatment of musculoskeleta

Chronic stress may have a direct influence on pain.

Increased basal mechanical pain sensitivity but decreased

in a human model of relative hypocortisolism

Pain, Volume 149, Issue 3, Pages 539-546 (June 2010)

Linn K. Kuehla, Gilles P. MichauxbCorresponding Author Inf

address, Steffen Richtera, Hartmut Schchingera, Fernand An

Received 5 October 2009; received in revised form 18 March

March 2010. published online 09 April 2010.

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Abstract

Clinical data have accumulated showing that relative hypocort

be regarded as a neuroendocrinological correlate of chronic str

characteristic of some functional pain syndromes. However, it

clarified yet whether deregulations of the hypothalamuspituit

axis may directly alter pain perception and thus be causally in

pathophysiology of these disorders. To test this hypothesis, we

randomized placebo-controlled crossover trial in N=20 healthy

volunteers (median age 24yrs) and analyzed the effects of met

hypocortisolism on quantitatively assessed basal mechanical p

13m/s impact stimuli), perceptual wind-up (9m/s impact stimu

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temporal summation of pain elicited by inter-digital web pinch

pressure stimuli for 2min). Experimentally induced hypocortis

decreased pain detection thresholds and augmented temporal s

induced pain (p


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The 2 threshold hypothesis of dose suggests that a therapeutic dose (normalisation of signs and symptoms) for lumthreshold of around 12-14kg and another threshold occurs with a deterioration of signs and symptoms at around

extent depending on the stage, stability, irritability and stability of the disord

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IL-6 mice, mechanoallodynia (as assessed with von Frey filaments) was markedly delayed. Sympathetic invasion DRG, and the formation of pericellular axonal baskets were all significantly reduced in the IL-6 knockout mice co

results imply a facilitatory role for IL-6 in pain and sympathetic sprouting induced by nerve injury, and add to the neuropathological events.

Author Keywords: Sympathetic sprouting; Allodynia; Hyperalgesia; DRG; Cytokines; Mice

Index Terms: spinal nerve; nerve injury; allodynia; hyperalgesia; interleukin 6

link to Pain Journal

Neurophysiology of Pain and Inflammation

Clinical example using mechanical traction

Presentation on Stress, Exercise and the Immune System

Mechanical traction neurophysiology conceptualised and conceived predominantly during early 1995 as pa

University - for references see below as well as the paper on pain and inflammation elsewhere on this site.

Melzack R (1999) From the gate to the neuromatrix. Pain Supplementation 6; S121-S126

Newport DJ, Nemeroff CB (2000) Neurobiology of post traumatic stress disorder. Current Opinion in Neurobiolo

Goldstein JA (2004) Tuning the Brain. Principles and practice of neurosomatic medicine. The Hawthorn Press Ne

Grossberg S (2000). The complimentary brain: unifying brain dynamics and modularity. Trends in Cognitive Scie

The Dorsal Root Ganglion, the Intervertebral Foramen and Musculoskeletal

by Martin Krause, 1995 & 2000.

SUMMARY

The efficacy of manual therapy interventions has been extensively criticised in recent years. Serious charges of ph

disease (nocebo) leading to chronicity have been raised. Paradoxically, the omission of higher centre processing in

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investigations, results in a dichotomy of interpretation which, either justifies the determination of inefficacy or alt

for higher centre involvement during the selection and application of manual therapy techniques. Specifically, the

motivational-affective responses require dissemination if hypotheses regarding the efficacy of manual therapy trea

be made. Currently, the majority of pain research has established immune-nervous system responses associated w

than repair. Recently, dysfunction of the dorsal root ganglion (DRG), which lies in the intervertebral foramen (IVF

genesis and chronicity of radicular pain. Previously, manual therapy techniques to the IVF, such as traction, have

normalise signs and symptoms in acute radicular pain. Clinicians use the presenting signs and symptoms, to guide

Additionally, the normalisation of signs and symptoms is used to demonstrate the usefulness of a treatment techni

demonstrate higher centre involvement in the reduction of pain and inflammation. Clearly, if the efficacy of manu

differentiation between a treatment dependent descending inhibition of pain and inflammation, with that of a plac

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See the following link for a greater explanation of the neuro-immune-inflammatory cascade as it relates to exerciscognitive behavioural therapy.

Immune System and Musculoskeletal Dysfunction

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