role of mobilization in pain

can somebody explain the role of mobilization of the vertebrae in relieving pain, cos i read in this forum that cervical mobilization at the c456 level will result improved ROM and result in tremendous pain relief in Periarthritis shoulder patients and it actually did, nearly 90% of my PA shoulder have got good results, i wonder how this mechanism works, are there any published literature, or is it the experience of the therapist who proposed this. awaiting for your reply, thanks, bye

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<pagetext>Hey,

Let’s see if I can help ya. I'll break it off into paragraphs because there is more going on than just the mobilization

Mobilization:
The Spinal Nerve Roots are the connection between the Peripheral Nervous System and the Central Nervous System. The Nerve Root passes through a confined space where it is susceptible to deformation or dysfunction. By mobilizing the vertebrae, you are relieving the effects of low level pressure on the C4,5,6 nerve roots. Low level pressure can affect microcirculation of the nerve itself, inhibit axonal transport, and may structurally damage the axon.

Stretch Reflex:
Mobilizing the vertebral bodies force the intrinsic muscles of the spine as well as all the muscles attaching into the spinal processes into a high speed (explosive) stretch. A muscle placed into such a predicament will have its stretch reflex activated and will be forced to lose tone to prevent injury to the muscles. Once the mobilization is completed, proprioceptive sensors in the tendons will send new signals to the brain on its current status (length). Then the brain decides if the tone needs to be increased to acceptable levels. Let’s call it a muscle "reboot" if you will. Any cyclic (pain/spasm cycle) protective splinting will be removed as the main noxious stimulus is now gone (chronic cases only).

Pain Referral:
As we all know the brain and spinal cord are enigmas. The brain and spinal cord affect all information coming in from the peripheral nervous system. Chronic pain IMHO has been a case of mistaken identity where the butler (referral pattern) is the only person (is the location) who can commit a murder (of the source of pain) (read brackets to understand sentence... it's a long night). By reducing the effects of low level pressure on the nerve roots by mobilization, the nerves function better (send and receive input). By using the stretch reflex through mobilization, muscle length increase thereby increasing blood flow in the area and relieving noxious stimulus. These two effects will decrease pain felt in the referral area.

Arthritis of the GH Joint:
Let’s face it, it's not a "true" joint. The only way the joint surfaces articulate is when the muscles "force" it to. I have seen shoulders that made me cross eyed on how bad they were and the patient expressed mild if any discomfort. So... (knowing that people may have a different opinion) what really causes shoulder pain is if the muscles affect PCIR of the humeral head.

The End of this Long Post:
IMHO, simple mobilization of C4,5,6 will not end the person's shoulder pain. If it does, then it may have been intrinsic muscles or muscles with origins in the TVP's or SP's themselves that have referred pain into the GH joint area. Also the nerves are functioning better after the mobilization reduced low level pressure on the nerve roots allowing the nerve to not reach threshold (through noxious stimulus) thereby decreasing tone into the affected muscles. If it is a TRUE shoulder pain, PCIR of the humeral head needs to be done and the appropriate muscles rehabilitated.

Hope I did not bore ya
Adamo