Keywords
Manipulation
Spinal biomarkers
Inflammation
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Abstract
Objective: To analyze the effects of vertebral manipulations (VM) in adults with low back pain, assessing pain and immunological markers. Methods: This systematic review study (PROSPERO CRD42024577322) followed the PRISMA (2020) statement and the PICO strategy, based on the guiding question: "What are the effects of vertebral manipulations in adults with low back pain in reducing pain intensity and modulating immunological markers?". Following predefined inclusion and exclusion criteria, a search was conducted in the Scielo, PubMed, BVS, and PEDro databases. Out of 48 articles found, only 4 were selected for the review. Results: The analyzed studies were clinical trials, using osteopathic manual therapy or high-velocity, low-amplitude spinal manipulation, following different protocols with control groups. Pain was measured using the Visual Analog Scale (VAS). The immunological markers analyzed included cytokines, chemokines, NPY, E-selectin, vitamin D, and C-reactive protein (CRP). Final considerations: VM effectively reduces pain in both acute and chronic low back pain and modulates biomarkers such as CRP, IL-6, IL-10, and TNF-α. The results suggest that VM is a promising and less invasive approach. Further studies are needed to identify which biomarkers are most effective in monitoring clinical progress and guiding personalized treatments.
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