The Thrust - A Must? : a literature review of the effectiveness of thrust manipulation for pain relief in musculoskeletal conditions

Abstract

Background: Musculoskeletal pain is a quite common, disabling, and costly issue in our society. A technique used by manual therapists to facilitate pain relief for these conditions is the high-velocity/low-amplitude thrust (HVLA-T) and while there exist studies showing its effectiveness for pain relief in specific regions or conditions, such as for non-specific lower back pain (NLBP), there is not much data regarding its pain relief qualities in a broader sense.

Objective: To investigate the effectiveness of HVLA-T in terms of pain relief for patients suffering from musculoskeletal conditions.

Method: A review of current literature (<=5y) on CINAHL and PubMed.

Result: 8 articles were considered eligible, compromising a total of 873 participants. Articles included were assessed for quality through use of the PEDro scale as well as assessed with regards to ethics. A trend of significant and often clinically important reductions of pain and pain-related aspects was shown.

Conclusion: HVLA-T is an effective manual technique in terms of pain-relief to a subgroup of patients suffering from musculoskeletal conditions. However, there is not significant difference in between-group comparisons of other techniques or sham procedures. More research is needed into the mechanisms of HVLA-T to find the ruling factor of patient outcomes as well as a comparison of different manual therapeutic modalities for pain-relief.