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Disease Markers
Volume 2014, Article ID 815379, 7 pages
Research Article

Tissue Damage Markers after a Spinal Manipulation in Healthy Subjects: A Preliminary Report of a Randomized Controlled Trial

1Centro de Fisioterapia y Psicología Soluciona, 18002 Granada, Spain
2Department of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
3Department of Health Sciences, Universidad de Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain
4Servicio de Análisis Clínicos, Hospital Médico-Quirúrgico del Complejo Hospitalario de Jaén, Servicio Andaluz de Salud, 23007 Jaén, Spain

Received 25 September 2014; Accepted 10 December 2014; Published 25 December 2014

Academic Editor: Benoit Dugue

Copyright © 2014 A. Achalandabaso et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Spinal manipulation (SM) is a manual therapy technique frequently applied to treat musculoskeletal disorders because of its analgesic effects. It is defined by a manual procedure involving a directed impulse to move a joint past its physiologic range of movement (ROM). In this sense, to exceed the physiologic ROM of a joint could trigger tissue damage, which might represent an adverse effect associated with spinal manipulation. The present work tries to explore the presence of tissue damage associated with SM through the damage markers analysis. Thirty healthy subjects recruited at the University of Jaén were submitted to a placebo SM (control group; ), a single lower cervical manipulation (cervical group; ), and a thoracic manipulation . Before the intervention, blood samples were extracted and centrifuged to obtain plasma and serum. The procedure was repeated right after the intervention and two hours after the intervention. Tissue damage markers creatine phosphokinase (CPK), lactate dehydrogenase (LDH), C-reactive protein (CRP), troponin-I, myoglobin, neuron-specific enolase (NSE), and aldolase were determined in samples. Statistical analysis was performed through a mixed-model ANOVA. Neither cervical manipulation nor thoracic manipulation did produce significant changes in the CPK, LDH, CRP, troponin-I, myoglobin, NSE, or aldolase blood levels. Our data suggest that the mechanical strain produced by SM seems to be innocuous to the joints and surrounding tissues in healthy subjects.