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Casper Glissmann Nim

Casper Nim

Ph.d. studerende
Kiropraktor Casper Glissmann Nim
Rygcenter Syddanmark, Middelfart Sygehus




Ph.d. projekt

What determines a positive outcome of spinal manipulation for persistent low back pain: Pain stiffness or pain sensitivity?



One of the most commonly used treatments for spinal pain is joint manipulation — a procedure in which a skilled practitioner seeks to normalize mechanical function in the spine through application of manual force. National and international clinical guidelines recommend spinal manipulation as a first-line treatment option for spinal pain, as there is evidence that it is both effective, safe, and inexpensive. Unfortunately, it is difficult to reliably identify clinically relevant joint stiffness and thus to determine beforehand whether manipulation is the best choice for a given patient.

The primary aim of this study is to determine whether manipulation is more effective in terms of pain relief when directed at spinal segmental stiffness or segmental pain sensitivity in persistent low back pain. Futhermore, to examine whether manipulation ‘normalizes’ these two seemingly relevant factors.

Up to 50 persistent low back pain patients will be included in the project and examined for spinal stiffness and pain sensitivity. Stiffness is measured using a custom experimental apparatus to quantify mechanical indentation and pain sensitivity is assessed using quantitative sensory pain testing. In each case, the patient will be randomly allocated to receive manipulation either at the spinal segment with the highest degree of mechanical stiffness or the segment with the highest degree of pain sensitivity.
The results are expected to help guide clinicians when determining which patients are likely to benefit from spinal manipulation and which are not, thus optimizing the patients course of treatment. Furthermore, the results will cast new light on the basic mechanisms underlying spinal manipulation.



1. januar 2018 - 31. december 2020



Forskningsleder, professor, overlæge, PhD Berit Schiøttz-Christensen
Rygmedicin, Rygcenter Syddanmark



Søren O’Neill, kiropraktor, klinisk lektor, Ph.D., M. Rehab. Rygmedicin, Rygcenter Syddanmark.
Greg Kawchuk, Kiropraktor, Adjungeret Professor, Ph.D., Syddansk Universitet

Publikationer og aktiviteter

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