Introduction
tumor necrosis, pain
INFLAMMATION, TUMOR NECROSIS
Spinal mobilisations/manipulation is commonly used in the management of people with spinal painSystemic inflammatory markers, such as high sensitive c-reactive protein (hsCRP) and tumor necrosis factor (TNF)-α may be elevated in people with persistent neck painSeveral studies have explored the effects of joint mobilisation/manipulation on neuroimmune responses in people with low back painTo our knowledge, only one randomised controlled trial explored the association between systemic neuroimmune responses, spinal mobilisation/manipulation and pain reduction in patients with non-specific neck painConfounding factors, such as variations in medication use, medical co-morbidities, alcohol usage, psychological stress, sleep, and cyclical variations in neuro-endocrine-immune responses, complicate the study of long-term effects of interventions on systemic inflammation. Omitting these confounders may induce significant bias as these factors may induce variability over time