The changes of brain metabolism after spinal manipulation in patients with chronic nonspecific low back pain: a MRS study

Motivation: Bridge the knowledge gap in understanding the central mechanisms of chronic low back pain (CLBP) and the effects of spinal manipulation (SM). Goal(s): To use 1H-MRS to investigate metabolic differences in the posterior cingulate cortex (PCC) during spinal manipulation for chronic low back pain (CLBP). Approach: The approach involved recruiting CLBP patients and healthy controls, performing 1H-MRS in the posterior cingulate cortex (PCC) before and after spinal manipulation (SM), and correlating metabolite changes with clinical outcomes. Results: CLBP patients exhibited altered brain metabolism in the posterior cingulate cortex (PCC), with changes in specific metabolites, and these abnormalities improved after spinal manipulation (SM). Impact: The research provides insights into the central mechanisms of chronic low back pain (CLBP) and the potential therapeutic benefits of spinal manipulation, which could inform better pain management strategies.