Dear Siobhan,

Unfortunately to my knowledge a very few studies has been published on the effects of manual oscilatory techniques in patients with musculoskeletal disorders to support the theory that the autonomic nervouw system can be affected by manual oscillations.

There is sufficient evidence that the nervous system (more specifically the sympathetic part of the nervous system) may contribute to the pathopghysiology of joints, more specifically rheumatoid arthritis (neurogenic inflammation). Continuously increased nociceptive activity (as in chronic arthritis) could lead to peripheral and central sensitization of polymodal nociceptive afferents and to an increased activity of the sympathetic nervous system. See references in the attached file (Dhondt et al, 1999). Effects of peripheral and central sensitization could manifest themsleves in a reduced pain tolerance and threshold. If patients with chronic arthritis appear to have reduced pain tolerance and threshold, this could be an indication of the existence of neurognic inflamnmation. See reference in attached files (Hogeweg et al, 1995). You can find more recent references in PUBMED.

Based on the mechanisms of gate controls in the nervous system, it may be that inhibition of nociceptive impluse activity and of the activity of sympathetic neurons is achieved by stimulation of unimodal mechanosensory units of joints. Therefore we investigated in the past (1999) the effects of manual oscillations of the spinal joints (defined as rhytmical passive mobilisations of the joint with continuously equal amplitude). If manual oscillations were able to inhibit nociceptive and/or sympathetic activity, we would expect an increase in pain tolerance and threshold (hypothesis). The results of this study are described in Dhondt et al, 1999.

I hope you have some input data for your research and wish you much success.

With kind regards from the Netherlands,

Rob Oostendorp, PhD, Msc, PT, MPT,

emeritus professor Radboud University Nijmegen, The Netherlands.

Dearest Rob, Thank you so much for your answer.It was very helpful and confirms what Leyderman states in his book, The science and practice of manual therapy. He also says that the mechano-receptors being activated will interrupt and over-ride the nociceptors, in the patients perception of the area of pain. I look forward to having a look at the research that you have alluded to ( although I could nt see an attached file?) many thanks again, have a wonderful day. Siobhan

Dear Siobhan,

Attached you will find the mentioned references of Dhondt et al (1999) and Hogeweg et al (1996) and some other references of Hogeweg and VanderWeeën.

Best greetings,

Rob Oostendorp

You can find the other references in ResearchGate (Rob AB Oostendorp).

Rob Oostendorp

Dearest Giovanni, Thankyou so much for your response. Im just going to go have a look now at the information you provide. Many many thanks, sincerely, Siobhan

There is effects on neurovegetative system from rythmic neck mobilisation see the various studies from Bill Vincenzino and Bialosky (The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model).

Thank you very much Benjamin, That is indeed a very nice piece of research that you have directed me to. Much appreciated , Siobhan