Feasibility Assessment of Neurophysiological Measurement in Veterans With LBP

Eksperimentel: Spinal manipulation

Participants will receive a lumbar SMT technique previously described in the literature and commonly utilized for the treatment of low back pain . The SMT will be performed four times (two times on each side) in a 5-minute period. In addition, the following will be performed: Functional MRI (fMRI), Behavioral: Pain Sensitivity Testing, Questionnaires,Behavioral: Physical Impairment.

Procedure: Spinal manipulation

Participants will receive a lumbar SMT technique previously described in the literature and commonly utilized for the treatment of low back pain . The SMT will be performed four times (two times on each side) in a 5-minute period. In addition, the following will be performed: Functional MRI, Behavioral: Pain Sensitivity Testing, Questionnaires,Behavioral: Physical Impairment.

Procedure: fMRI

Both groups will receive an fMRI.

Andre navne:

• Funktionel MR

Adfærdsmæssigt: Pain Sensitivity Testing

Both groups will receive an Pain Sensitivity Testing

Andet: Questionnaires

Both groups will receive Questionnaires

Adfærdsmæssigt: Physical Impairment

Both groups will receive testing on physical impairment.

Sham-komparator: Therapeutic touch

Participants in this group will lie prone. The therapist will place both hands in contact with the participants' pelvis across the top of the posterior aspect of the sacrum and ilia and apply a downward force to keep the pelvis in contact with the table. This group accounts for effects of time and personal contact. The amount of "hands-on" contact will be equivalent between groups. Both groups will be given the same verbal instructions regarding the techniques performed. In addition, the following will be performed: Functional MRI (fMRI), Behavioral: Pain Sensitivity Testing, Questionnaires,Behavioral: Physical Impairment.

Procedure: fMRI

Both groups will receive an fMRI.

Andre navne:

• Funktionel MR

Adfærdsmæssigt: Pain Sensitivity Testing

Both groups will receive an Pain Sensitivity Testing

Andet: Questionnaires

Both groups will receive Questionnaires

Adfærdsmæssigt: Physical Impairment

Both groups will receive testing on physical impairment.

Procedure: Therapeutic touch

Participants in this group will lie prone. The therapist will place both hands in contact with the participants' pelvis across the top of the posterior aspect of the sacrum and ilia and apply a downward force to keep the pelvis in contact with the table. This group accounts for effects of time and personal contact. The amount of "hands-on" contact will be equivalent between groups. Both groups will be given the same verbal instructions regarding the techniques performed. In addition, the following will be performed: Functional MRI, Behavioral: Pain Sensitivity Testing, Questionnaires,Behavioral: Physical Impairment.

fMRI during testing of pain changes from approximately Day 3 and Day 5

fMRI during quite rest changes from approximately Day 3 and Day 5

Pain Sensitivity Testing changes from Day 3, Day 4 and Day 5

This measure thermal threshold and tolerance using continuous heat stimulus delivered to the participants' dominant arm. The stimulus will start at 35°C and will be increased at a rate of 0.5°C with participants terminating the stimulus when the temperature reached pain threshold ("when the sensation first transitions from heat to pain") and tolerance ("when the sensation becomes so strong you want to remove it from your skin"). Threshold and tolerance measures will also be collected using mechanical pressure applied using a Fischer Dolorimeter. During Dolorimeter testing, force is slowly increased until the subject indicates that the sensation changes from pressure to pain.

Pain Intensity

Pain visual analog scale is a 10cm long line. The line is anchored at one end with 'none' or 'not bad at all' and at the other with 'worst imaginable.' Participants are asked to rate their pain at rest by placing a mark along the 10cm line. Participants will also rate pain during active trunk range of motion using the same scale.

McGill Pain Questionnaire-2

This is 22-item questionnaire that asks participants to describe the intensity of varies qualities of the pain that he or she is experiencing; for example, throbbing or itching.

Physical Impairment

A physical impairment scale consists of 7 different examination procedures that assess lumbar and hip range of motion, muscle performance of trunk musculature, and response to palpation. Scores is 0 - 8, Range is 0 is no impairment and 8 is completely impaired.

Oswestry Disability Questionnaire (ODQ)

The ODQ has a range of 0 (no disability due to back pain) to 100 (completely disabled due to back pain), so higher scores indicate higher disability from LBP.