Together, neck pain and back pain are the first cause of disability worldwide, accounting for more than 10% of the total years lived with disability. In this context, chiropractic care provides a safe and effective option for the management of a large proportion of these patients. Chiropractic is a healthcare profession mainly focused on the spine and the treatment of spinal disorders, including spine pain. Basic studies have examined the influence of chiropractic spinal manipulation (SM) on a variety of peripheral, spinal and supraspinal mechanisms involved in spine pain. While spinal cord mechanisms of pain inhibition contribute at least partly to the pain-relieving effects of chiropractic treatments, the evidence is weaker regarding peripheral and supraspinal mechanisms, which are important components of acute and chronic pain. This narrative review highlights the most relevant mechanisms of pain relief by SM and provides a perspective for future research on SM and spine pain, including the validation of placebo interventions that control for placebo effects and other non-specific effects that may be induced by SM.

中文翻译：

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整脊手法治疗脊柱疼痛的神经生理机制

颈痛和背痛是全球残疾的首要原因，占残疾总年数的 10% 以上。在这种情况下，脊椎按摩疗法为大部分患者的管理提供了一种安全有效的选择。整脊是一个医疗保健专业，主要专注于脊柱和脊柱疾病的治疗，包括脊柱疼痛。基础研究检查了脊椎按摩疗法 (SM) 对涉及脊柱疼痛的各种外周、脊柱和脊柱上机制的影响。虽然抑制疼痛的脊髓机制至少部分有助于整脊治疗的疼痛缓解作用，但关于外周和脊髓上机制的证据较弱，这些机制是急性和慢性疼痛的重要组成部分。