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Mode d’action des manipulations vertébrales

Mechanism of action of spinal thrust manipulations

  • Revue de la Littérature / Literature Review
  • Published:
La Lettre de médecine physique et de réadaptation

Résumé

Les manipulations vertébrales agissent sur les différents composants de l’unité fonctionnelle vertébrale. Elles séparent les surfaces articulaires des articulations zygapophysaires, ce mouvement étant accéléré lors de la survenue du bruit de craquement. Elles semblent diminuer brièvement la pression intradiscale. Elles étirent en force les muscles paravertébraux, ce qui favorise leur relaxation par des mécanismes encore mal explorés. Enfin, elles ont probablement un effet antalgique propre indépendant de la lésion en cause. Ces actions sont bénéfiques dans le cadre du traitement des douleurs vertébrales, mais elles sont toutes de courte durée. Un effet thérapeutique prolongé ne peut être expliqué que par une action réflexe telle que la rupture d’un cercle vicieux de type douleur-spasme-douleur ou par l’existence d’une lésion spécifique, dite lésion manipulable, non prouvée.

Abstract

Spinal thrust manipulations act on the different constituent elements of the vertebral motion segment. They separate the facet joint surfaces, with faster separation accompanied by a cracking noise. They appear to briefly lower the intradiscal pressure. They forcefully stretch the paraspinal muscles, thereby relaxing these muscles via an as yet poorly understood mechanism. They are also likely to have an inherent analgesic effect that is independent of the nature of the pain-causing lesion. While these actions are beneficial in the treatment of pain of vertebral origin, they are short-lived. A long-term therapeutic effect could be accounted for only in terms of a reflex phenomenon, such as the breaking of a vicious cycle of pain-spasm-pain, or by the existence of a specific “manipulable” lesion, for which, however, no proof has been furnished to date.

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  1. Service de médecine physique, Hôtel-Dieu, place du Parvis-de-Notre-Dame, F-75004, Paris, France

    J. -Y. Maigne

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Maigne, J.Y. Mode d’action des manipulations vertébrales. Lett Med Phys Readapt 27, 153–158 (2011). https://doi.org/10.1007/s11659-011-0281-4

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  • DOI: https://doi.org/10.1007/s11659-011-0281-4

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