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ON Chiropractic and for researchers comparing the efficacy of various interventions. This Recommended Reading is an active area of research in Dr. Srbely’s lab. ∞∞ What is the cause-effect relationship  OCA. “Osteoarthritis: Understanding pain and treatment.” ON Chiropractic (Winter 2015): 16-21. between C-Sens and other pathologies? C-Sens has been linked to several conditions, but the causality has not yet been clearly established. ∞∞ How long does the effect of SMT last  Srbely, JZ. “Spinal manipulative therapy and its role in the prevention, treatment and management of chronic pain.” JCCA (2012): 56(1). : Srbely, JZ. “Chiropractic science: A contemporary neurophysiologic paradigm.” JCCA (2010) 54(3):144-146. when modulating C-Sens? How does it compare to other therapies? ∞∞ What is the nature of the relationship between C-Sens, myofascial trigger points and myofascial pain syndrome? This is an active research question.  Derjean, D et al. “Dynamic balance of metabotropic inputs causes dorsal horn neurons to switch functional states.” Nat Neurosci (2003 Mar) 6(3):274-81. b Maguire, G. “Myofascial pain syndrome: Current concepts & management.” RRS Education Research Reviews (2011). Online. Q Ustinova, EE et al. “Sensitization of pelvic nerve afferents and mast cell Possibilities for the Profession infiltration in the urinary bladder following chronic colonic irritation W 292(1):F123-F130. hile more research is needed, exciting possibilities for chiropractic science and practice are emerging. Consider a patient whose C-Sens is triggered by something that is musculoskeletal in nature (e.g., a muscle injury or chronic joint degeneration). Resolving this injury may also resolve a series of secondary issues which may potentially stem from C-Sens and neurogenic inflammation. For chiropractors who have observed this effect in the clinic, this research may offer a scientific explanation for these experiences. The primary cause of C-Sens can be non-musculoskeletal in nature (e.g., a tumour). While SMT cannot address these other causes, clinicians may be able to modulate C-Sens by “closing the gate” using SMT and other therapies. This way, clinicians could potentially halt or mitigate the establishment of secondary conditions of C-Sens and neurogenic inflammation. is mediated by neuropeptides.” Am J Physiol Renal Physiol (2007)  Srbely, JZ et al. “Dry needle stimulation of myofascial trigger points evokes segmental anti-nociceptive effects. J Rehabil Med. 2010; 42(5):463-8.  Srbely, JZ. “New trends in the treatment and management of myofascial pain syndrome.” Curr Pain Headache Rep (2010) 14:346–352.  Srbely, JZ et al. “Capsaicin-induced central sensitization evokes segmental increases in trigger point sensitivity in humans.” J Pain (2010) 11(7):636-43.  Srbely, JZ et al. “Immediate effects of spinal manipulative therapy on regional antinociceptive effects in myofascial tissues in healthy young adults.” J Manipulative Physiol Ther (2013); 36:333–341.  Moayedi, M and Davis, KD. “Theories of pain: From specificity to gate control.” Journal of Neurophysiology (2012) 109:5-12.  World Health Organization. “Acupuncture: Review and analysis of reports on controlled clinical trials.” Geneva: World Health Organization (2002). Online: http://apps.who.int/iris/handle/10665/42414  Srbely, JZ et al. “Stimulation of myfascial trigger points with ultrasound induces segmental antinociceptive effects: A randomized controlled study.” Pain (2008) 139(2):260-6. www.chiropractic.on.ca 15