The immediate effect of low back manipulation on serum cortisol levels in adult males with mechanical low back pain

Purpose - To determine if serum cortisol levels are increased following spinal manipulative therapy (SMT) to the low back region and to determine the effect of a short rest interval on daytime serum cortisol levels.

Method - The research was in the form of a randomized, clinical trial, using human subjects, with informed consent and ethics committee approval.

Setting: Patients presenting with low back pain to the Chiropractic Day Clinic at the Durban University of Technology and the Community Health and Indigent Programme Services Clinicin the Discipline of Clinical Anatomy at the Nelson R Mandela School of Medicine.
Subject: Adult, male patients, aged between 18 and 35 years of age, diagnosed with mechanical low back pain.
Outcome measures: Daytime serum cortisol levels.

Results - An increase in the rate of change of daytime serum cortisol levels following SMT. Serum cortisol levels decreased significantly following a short rest interval.

Conclusion - The results of this study support the fact that a neuroendocrine effect can be stimulated by SMT. A short-term rest period also influenced the serum cortisol levels. However, the mechanism of these effects is not established and requires further investigation, not within the scope of the present study.