Effects of thoracic manipulation with trigger point therapy on inflammatory cytokine levels in individuals with multiple sclerosis: a pilot study.

Only 21 participants completed the study, and it was a pilot with no formal hypothesis testing, so differences are exploratory rather than proof. Blood samples were taken only at 20 minutes and 2 hours after treatment, which may have missed earlier or longer-lasting cytokine changes. The treatment group received thoracic manipulation together with trigger point therapy, so the effect of either part alone cannot be separated. Participants had mild disability and were fully ambulatory without aid, so results may not apply to people with more advanced MS. Medication and disease-modifying therapy details were not collected, and blood collection time and physical activity varied, which can affect inflammation markers. The sham procedure used palpation and a device set to zero, but the treating chiropractor was not blinded, though participants, assessors and analysts were blinded.

The work was funded by the Australian Spinal Research Foundation, grant TRG2020-3. The authors declared financial support for the work or publication.

Do not read the larger GM-CSF and IL-17A changes as proof that thoracic manipulation helps inflammation or symptoms in multiple sclerosis. This was a 21-person pilot with no hypothesis testing, most markers barely changed, symptoms did not improve, and the treatment included palpation, trigger point therapy, and manipulation, so their separate effects cannot be separated.