Manipulação vertebral na lombalgia: avaliando os efeitos na intensidade da dor e nos marcadores imunológicos

##plugins.themes.bootstrap3.article.main##

Carlos Eduardo Duarte Moraes
Joane Severo Ribeiro
Alessandra Peres

Resumo

Objetivo: Analisar os efeitos das manipulações vertebrais (MV) em adultos com dor lombar, avaliando a dor e os marcadores imunológicos. Métodos: Estudo de revisão sistemática (PROSPERO CRD42024577322), seguiu a declaração PRISMA (2020), estratégia PICO, a partir da pergunta norteadora: “Quais os efeitos das manipulações vertebrais em adultos com dor lombar na redução da intensidade da dor e na modulação dos marcadores imunológicos?”. Foi realizada uma busca nas bases Scielo, PubMed, BVS e PEDro, seguindo critérios de inclusão e exclusão predefinidos. Dos 48 artigos encontrados, apenas 04 foram selecionados para compor a revisão. Resultados: Os estudos analisados eram ensaios clínicos, com tratamento manual osteopático ou manipulação espinhal de alta velocidade e baixa amplitude, em protocolos distintos e com grupos controle, utilizaram a escala EVA para mensuração da dor. Os marcadores imunológicos analisados foram citocinas, quimiocinas, NPY, E-selectina, vitamina D e proteína C reativa. Considerações finais: A MV mostra eficácia na redução da dor em lombalgia aguda e crônica e na modulação de biomarcadores como PCR, IL-6, IL-10 e TNF-α. Os resultados sugerem que a MV é uma abordagem promissora e menos invasiva. Mais estudos são necessários para identificar quais biomarcadores mais eficazes para monitorar a evolução clínica e guiar tratamentos personalizados.

##plugins.themes.bootstrap3.article.details##

Como Citar
MoraesC. E. D., RibeiroJ. S., & PeresA. (2024). Manipulação vertebral na lombalgia: avaliando os efeitos na intensidade da dor e nos marcadores imunológicos. Revista Eletrônica Acervo Saúde, 24(12), e18241. https://doi.org/10.25248/reas.e18241.2024
Seção
Revisão Bibliográfica

Referências

1. ALMUSHAIQEH NA, et al. Effectiveness of Manipulation and Mobilization in Chronic Back Pain-A Systematic Review. Int J Recent Innov Med Clin Res, 2020; 2(4): 84-91.

2. BRASIL AVB, et al. Success and failure after surgery of degenerative disease of the lumbar spine: an operational definition based on satisfaction, pain, and disability from a prospective cohort. BMC Musculoskelet Disord, 2022; 23(1): 501.

3. BRONFORT G, et al. Effectiveness of spinal manipulation and biopsychosocial self-management compared to medical care for low back pain: a randomized trial study protocol. BMC Musculoskelet Disord, 2023; 24(1): 415.

4. CANLI K, et al. Systemic Cytokine Level Differences in Patients with Chronic Musculoskeletal Spinal Pain Compared to Healthy Controls and Its Association with Pain Severity: A Systematic Review. Pain Medicine, 2022; 23(12): 1947–1964.

5. CHANG WJ, et al. Systemic pro- and anti-inflammatory profiles in acute non-specific low back pain: An exploratory longitudinal study of the relationship to six-month outcome. PLoS One, 2023; 18(6): 287192.

6. DUARTE FCK, et al. Preliminary Insights into the Effects of Spinal Manipulation Therapy of Different Force Magnitudes on Blood Biomarkers of Oxidative Stress and Pro-Resolution of Inflammation Mediators. BioRxiv, 2023; 1228573549.

7. FERREIRA ML, et al. Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology, 2023; 5(6): 316-329.

8. FREITAS JP, et al. One spinal manipulation session reduces local pain sensitivity but does not affect postural stability in individuals with chronic low back pain: a randomised, placebo-controlled trial. Chiropr Man Therap, 2024; 32(20).

9. GEVERS-MONTORO C, et al. Reduction of Chronic Primary Low Back Pain by Spinal Manipulative Therapy is Accompanied by Decreases in Segmental Mechanical Hyperalgesia and Pain Catastrophizing: A Randomized Placebo-controlled Dual-blind Mixed Experimental Trial. The Journal of pain, 2024.

10. GONZALEZ CE, et al. Secreted chemokines reveal diverse inflammatory and degenerative processes in the intervertebral disc of the STZ-HFD mouse model of Type 2 diabetes. Preprint. BioRxiv, 2024; 7(31): 605332.

11. GU Y, et al. Global, Regional, and National Change Patterns in the Incidence of Low Back Pain From 1990 to 2019 and Its Predicted Level in the Next Decade. Int J Public Health, 2024; 69: 1606299.

12. HAMILTON T, et al. Association of prolonged symptom duration with poor outcomes in lumbar spine surgery: a Michigan Spine Surgery Improvement Collaborative study. J Neurosurg Spine, 2023; 39(4): 452-461.

13. JIANG BC, et al. Chemokines in chronic pain: cellular and molecular mechanisms and therapeutic potential. Pharmacology & Therapeutics, 2020; 212: 107581.

14. KARPOV SM, et al. Rehabilitation of patients with chronic low back pain. S.S. Korsakov Journal of Neurology and Psychiatry, 2022; 122(6): 14 19.

15. KLYNE DM, et al. Relationship between systemic inflammation and recovery over 12 months after an acute episode of low back pain. The Spine Journal, 2022; 22(2): 214-225.

16. KLYNE DM, et al. Systemic inflammatory profiles and their relationships with demographic, behavioural and clinical features in acute low back pain. Brain, Behavior, and Immunity, 2017; 60: 84-92.

17. KOOP MA, et al. Identifying the Most Important Confounders When Assessing the Association Between Low-Grade Systemic Inflammation and Musculoskeletal Pain: A Modified Delphi Study. Pain Medicine, 2021; 22(11): 2661–2669.

18. LE TL e NGUYEN TC. The effectiveness of spinal manipulation in patients with lower back pain due to spondylolisthesis. Y Dược cổ truyền Việt Nam, 2023; 49(2): 38-44.

19. LI W, et al. Assessing the causal relationship between genetically determined inflammatory biomarkers and low back pain risk: a bidirectional two-sample Mendelian randomization study. Front. Immunol, 2023; 14: 1174656.

20. LI W, et al. Peripheral and Central Pathological Mechanisms of Chronic Low Back Pain: A Narrative Review. J Pain Res, 2021; 14: 1483-1494.

21. LICCIARDONE JC, et al. Associations of Cytokine Concentrations With Key Osteopathic Lesions and Clinical Outcomes in Patients With Nonspecific Chronic Low Back Pain: Results From the OSTEOPATHIC Trial. J Am Osteophat Assoc, 2012; 112(9): 596-605.

22. MA B, et al. Objectively assessing visual analogue scale of knee osteoarthritis pain using thermal imaging. Displays, 2024; 84(11): 102770.

23. MATSUSHITA K, et al. Chemokine (C-C motif) Receptor 5 Is an Important Pathological Regulator in the Development and Maintenance of Neuropathic Pain. Anesthesiology, 2014; 120: 1491–1503.

24. PAPALIA GF, et al. Non-Invasive Treatments for Failed Back Surgery Syndrome: A Systematic Review. Global Spine J, 2023; 13(4): 1153-1162.

25. PICCHIOTTINO M, et al. The effect of a single spinal manipulation on cardiovascular autonomic activity and the relationship to pressure pain threshold: a randomized, cross-over, sham-controlled trial. Chiropr Man Therap, 2020; 28(7).

26. POPOV N. Assessment of the effectiveness of lumbar spinal manipulation in patients with mechanical low back pain. International Scientific Congress “Applied Sports Sciences”, 2022; 2: 445-449.

27. SCOTT A e BROOM D. Exercise Management for Referred Medical Conditions Routledge, 2022; 1: 500.
28. SEN O, et al. Can E-selectin be a reliable marker of inflammation in lumbar disc disease? Neurosurg Ver, 2005; 28: 214–217.

29. SICILIANO TB, et al. Spinal manipulation and mobilization forces delivered treating sciatica: a case report. Front. Integr. Neurosci, 2024; 18: 1356564.

30. TANEVA D, et al. Therapeutic guidelines in chronic low back pain. Pharmacia, 2021; 68(1): 117-120.

31. TEODORCZYK-INJEYAN JA, et al. Effects of spinal manipulative therapy on inflammatory mediators in patients with non-specific low back pain: a non-randomized controlled clinical trial. Chiropr Man Therap, 2021; 29(1): 3.

32. TEODORCZYK-INJEYAN JA, et al. Elevated Production of Nociceptive CC Chemokines and sE-Selectin in Patients With Low Back Pain and the Effects of Spinal Manipulation: A Nonrandomized Clinical Trial. The Clinical Journal of Pain, 2018; 34(1): 68-75.

33. TEODORCZYK-INJEYAN JA, et al. Elevated Production of Nociceptive CC Chemokines and sE-Selectin in Patients With Low Back Pain and the Effects of Spinal Manipulation: A Nonrandomized Clinical Trial. Clin J Pain, 2018; 34(1): 68-75.

34. THE LANCET R. The global epidemic of low back pain. The Lancet Rheumatology, 2023; 5(6): 305.

35. TIAN S, et al. Nucleus pulposus cells regulate macrophages in degenerated intervertebral discs via the integrated stress response-mediated CCL2/7-CCR2 signaling pathway. Exp Mol Med, 2024; 56: 408–42.

36. TONELLI ENRICO V, et al. The association of biomarkers with pain and function in acute and subacute low back pain: a secondary analysis of an RCT. BMC Musculoskelet Disord, 2022; 23(1): 1059.

37. WEBER KT, et al. Exploratory study for identifying systemic biomarkers that correlate with pain response in patients with intervertebral disc disorders. Immunologic Research, 2015; 63: 170-180.

38. WONG E, et al. Comparison of Effectiveness of Chiropractic Spinal Manipulation and Conservative Therapy for Low Back Pain. Journal of Orthopedics and Sports Medicine, 2023; 1-8.

39. ZHANG J, et al. E-selectin in vascular pathophysiology. Front. Immunol, 2024; 15: 1401399.