Sarah,
It would be very interesting to hear which patients you perform the
friction on and whether other techniques are incorporated. Doing 1/2 hour
of friction must be very hard work!!!
>1. Could it have been the placebo effect? I doubt it, but cannot
completely
>rule this out.
***Placebo is always a part of anyone's treatment but it would be unlikely
that it was completely placebo for the patient to have complete relief.
>2. Could both treatments have broken the pain cycle by affecting the local
>nociceptors, albeit in different ways?
***2 processes I can think of: Firstly, you may have caused a diffuse
noxious inhibitory process, whereby you provided a painful stimulus that
changed the processing of pain (this is possible, especially if the
friction technique produces pain for the patient). Secondly, you may have
increased the activity of the descending inhibitory system through
providing afferent input, which also occurs with techniques such as
massage and mobilizations/manipulations. For more on this, I would
recommend a read of "Textbook of Pain for therapists" by Strong et al.
There is currently no evidence that suggest malposition of joint cause
pain, and personally I believe if malposition was a problem, then it would
make the human body unbelievably fragile. But I guess as my chiropractic
colleague argue, an absence of evidence does not equal evidence of absence.
Henry***
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