The DNM is particularly directed towards the treatment of cutaneous nerves. These nerves carry all the body surface information, which is transmitted to the CNS. Information from the mechanoreceptors, of course, but also from all those fibres that will measure our external environment, temperature, skin chemistry, nutrition, pH, etc. And they have almost always been forgotten, or worse, neglected. I think this is because we don't see them: they don't seem as important as muscles, fascias, or other structures even sometimes imaginary. The human is thus made, he must see to believe.

Two important books confirm that tunnel syndromes are not reserved for "large" peripheral nerves, but that small nerves could also be affected. These books are: Nerve Injury and Repair by Göran Lundbord and Tunnel Syndromes by Marko M. Pećina.

DNM mainly treats neuropathic pain. It is not involved in pain whose causes are medical, such as injuries like cuts or fractures, deep somatic pain, visceral pain, and suspicious pain of unknown origin.

"Manual therapy has long been a component of physical rehabilitation programs, especially to treat those in pain. The mechanisms of manual therapy, however, are not fully understood, and it has been suggested that its pain modulatory effects are of neurophysiological origin and may be mediated by the descending modulatory circuit. Therefore, the purpose of this review is to examine the neurophysiological response to different types of manual therapy, in order to better understand the neurophysiological mechanisms behind each therapy’s analgesic effects. It is concluded that different forms of manual therapy elicit analgesic effects via different mechanisms, and nearly all therapies appear to be at least partially mediated by descending modulation. Additionally, future avenues of mechanistic research pertaining to manual therapy are discussed."

The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review

Andrew D. Vigotsky1 and Ryan P. Bruhns2

Hindawi Publishing Corporation
Pain Research and Treatment
Volume 2015, Article ID 292805, 11 pages

© 2019 par Louise Tremblay