Manual Therapy and MRI Changes

Manual therapy techniques appeared to change CNS activity in this study. PA pressures generated different changes compared to placebo pressures. It might therefore be interesting to see if complementary studies establish if these CNS changes are linked to clinical changes in the patient or if different techniques generate different CNS activity. Enjoy the read!

Neural response of PA lumbar mobilisations on MRI

Meier, M et al2013



A placebo, control, repeated-measures, single-blinded randomized study.


To test a clinically relevant method to mechanically stimulate lumbar functional spinal units while recording brain activity by means of functional magnetic resonance imaging (MRI).


Subjects were in the prone position with their face lying on a modified stabilization pillow. An experienced manual therapist applied controlled, non painful pressure stimuli to 10 healthy subjects at 3 different lumbar vertebrae (L1, L3, and L5). Pressure applied to the thumb was used as a control. The stimulation consisted of posterior to anterior(PA)pressure movement.


Stimulation of the lumbar spinous processes revealed bilateral neural responses in medial parts of the postcentral gyrus (S1). Additional activity was observed in the secondary somatosensory cortex (S2), posterior parts of the insular cortex, different parts of the cingulate cortex, and the cerebellum. Thumb stimulations revealed activation only in lateral parts of the contralateral S1.


The current study demonstrates the feasibility of the application of PA pressure on lumbar spinous processes in an MRI environment. This approach may serve as a promising tool for further investigations regarding neuroplastic changes in chronic low back pain subjects.

  • J Manipulative Physiol Ther 2014;37:32-41