Summary by Utah Sports and Wellness

Link to Original Article:

  • Randomized Placebo-Controlled Trial
  • PubMed Spine – January 2021
  • 35 References


The objective was to compare the immediate effect of Spinal Manipulation:

  • Included 59 patients with musculoskeletal pain.
  • 19 patients assigned to upper thoracic spinal manipulation, 20 patients assigned to thoracic myofascial work on the upper thoracic region, and 20 patients assigned to a placebo, which included an ultrasound without any current output.
  • Each patient received one intervention lasting 3 minutes.

There were a few patient exclusions:

  • Patients with previous spinal or back surgeries.
  • Pregnant women
  • Patients with rheumatologic diagnosis, tumors, pacemakers, cardiac arrhythmia, or heart transplant and open-heart surgery.
  • Patients who had consumed alcohol within the previous 24 hours.


  • Musculoskeletal pain is a major societal burden worldwide, affecting nearly 1.3 billion people globally.
  • Musculoskeletal pain increases the risk of cardiovascular events.
  • Only spinal manipulation induced immediate improvement in the parasympathetic activity of the heart.
  • Spinal manipulation on the upper thoracic spine led to an immediate improvement in the resting cardio autonomic control without having an effect on blood pressure.
  • Spinal manipulation was applied in the spine position with the arms wrapped around the chest.
  • Myofascial manipulation and placebo did not change cardiovascular autonomic control.
  • Manual therapy applied to the upper thoracic region is likely efficient to improve the cardiac autonomic control.