Effects of Upper Thoracic Manipulation on Pressure Pain Sensitivity in Women with Temporomandibular Disorder: A Randomized, Double-Blind, Clinical Trial
Abstract
Objective The aim of the present study was to evaluate the effects of upper thoracic manipulation on pain in subjects with temporomandibular disorder. Design Thirty-two women with a diagnosis of temporomandibular disorder were randomly allocated to an experimental group (n = 16), submitted to upper thoracic manipulation, and a placebo group (n = 16), submitted to a procedure in the thoracic region with no therapeutic effect. All volunteers underwent an evaluation of pain in the masticatory muscles and the temporomandibular joint using an algometer and the visual analog scale before and immediately after the procedure as well as after 48-72 hrs. Two-way repeated-measures analysis of variance was used for the intragroup and intergroup analyses, with the level of significance set to 5% (P Results No significant group-by-time interaction was found (P > 0.05) for algometry in any analysis, and Cohen d revealed no significant effect of the treatment. Moreover, no significant group-by-time interaction was found for facial pain intensity determined using the visual analog scale (P > 0.05), and Cohen d also revealed no significant effect of the treatment regarding this variable. Conclusions On the basis of the present findings, upper thoracic spinal manipulation does not lead to a reduction in pain in women with temporomandibular disorder.
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HVLA applied to the dorsal spine showed less consistent results.
“HVLA applied to the dorsal spine showed less consistent results [37].”
Only 6 studies accomplished more than 60% of the items listed in eTable 2.
“Only 6 studies accomplished more than 60% of the items listed in eTable 2. 57,66,67, 76 -78”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [76]
No statistical differences were found between MT targeted to the jaw and jaw exercises plus splint therapy, between cervical chiropractic adjustment and cervical trigger point therapy, upper thoracic manipulation and placebo, or masticatory muscle massage and splint for improving symptoms of patients with mixed TMD.
“However, no statistical differences were found between MT targeted to the jaw and jaw exercises plus splint therapy, 100 between cervical chiropractic adjustment and cervical trigger point therapy, 102 upper thoracic manipulation and placebo, 76 or masticatory muscle mas- sage and splint 104 for improving symptoms of patients with mixed TMD.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [76]
Cites
Validity of four pain intensity rating scales
Ferreira-Valente, M. A., Pais-Ribeiro, J. L., & Jensen, M. P. (2011) · Pain · doi:10.1016/j.pain.2011.07.005 · Cited by 1,872 · see citing works
Walser, R. F., Meserve, B. B., & Boucher, T. R. (2009) · Journal of Manual & Manipulative Therapy · doi:10.1179/106698109791352085 · Cited by 98 · see citing works
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Armijo-Olivo, S., Pitance, L., Singh, V., Neto, F., Thie, N., & Michelotti, A. (2016) · Physical Therapy · doi:10.2522/ptj.20140548 · Cited by 413 · see citing works
The treatment modalities of masticatory muscle pain a network meta-analysis
Feng, J., Luo, M., Ma, J., Tian, Y., Han, X., & Bai, D. (2019) · Medicine · doi:10.1097/md.0000000000017934 · Cited by 23 · see citing works
Chiaramonte, R., Ferrillo, M., de Sire, A., & Vecchio, M. (2026) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2026.2629282
“HVLA applied to the dorsal spine showed less consistent results [37].”
- Authors
- Packer, A. C., Pires, P. F., Dibai-Filho, A. V., & Rodrigues-Bigaton, D.
- Affiliations
- Methodist University of Piracicaba (BR)
- Corresponding author
- Rodrigues-Bigaton, Delaine
- Venue
- American Journal of Physical Medicine & Rehabilitation
- Published
- 2014-02
- Volume
- 93
- Issue
- 2
- Pages
- 160-168
- ISSN
- 0894-9115 (ISSN-L)
- OpenAlex
- W2040844256
- Cited by
- 31
- References
- 2
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 1 · 2020: 4 · 2019: 6 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 2 · 2014: 1
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physical Medicine & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- spinal manipulation, temporomandibular disorders, pressure pain sensitivity, masticatory muscles, temporomandibular joint pain, facial pain, women, placebo effect
- MeSH terms
- Adult, Double-Blind Method, Facial Pain, Female, Humans, Pain Measurement, Sex Factors, Temporomandibular Joint Dysfunction Syndrome, Thoracic Vertebrae, Time Factors, Reproducibility of Results, Treatment Outcome, Pain Threshold, Manipulation, Spinal, Young Adult
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