Manual therapy and transcranial magnetic stimulation in the pain control in knee osteoarthritis: literature review
Mannaly Mendonça, Camilla Fonseca, Maíra Lima, Luiz Mèlo, Sérgio Rocha, Marcelo Guerino, Ana Paula Lima, Maria das Graças Araújo, Kátia Monte-Silva
Background: Osteoarthritis (OA) is an incurable disorder that affects all joints and adjacent tissues, whose degeneration of articular cartilage results from a combination of factors; whereas knee osteoarthritis (KOA) is a disabling factor and pain is the major cause of physical limitations, reducing the mobility of elderly subjects. Objective: To verify the incidence of articles that discourse about manual therapy (MT) performance in the peripheral and central aspect of chronic pain and transcranial magnetic stimulation (rTMS) in the central aspect of pain. Method: Literature review conducted on Medline in English language without any date limit. The used and combined terms were Osteoarthritis, knee, chronic pain, musculoskeletal manipulations and transcranial magnetic stimulation. Articles with techniques of manual therapy and repetitive transcranial magnetic stimulation in chronic pain were included in the study. Whereas articles discussing association with other therapeutic techniques were excluded from the study. Results: It was found articles that analyzed subjects with chronic pain derived from KOA, investigated the behavior of the central nervous system of the subjects with KOA and the transcranial magnetic stimulation in the motor cortex of patients with chronic pain and also the performance of MT in the peripheral and central aspects of chronic pain. Conclusion: There is a need for studies that primarily investigate the effect of these two techniques in a short term and subsequently longer protocols to minimize pain in these patients.
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