# Rotating-pulling-poking manipulation effectively alleviates pain symptoms of lateral ankle sprain: an animal experimental study

## TL;DR

This study shows that a specific manipulation technique can reduce pain from ankle sprains in rats by affecting brain pathways and inflammation.

## Contribution

The study identifies the analgesic mechanism of Rotating-Pulling-Poking Manipulation through brain signaling and inflammation reduction in an animal model.

## Key findings

- The 5-minute manipulation group showed the best analgesic effect with reduced pain thresholds and weight-bearing differences.
- Manipulation increased MOR and 5-HT levels while decreasing BDNF, p-TrkB/TrkB, NR2A, and inflammatory markers in ankle tissues.
- The technique activates descending pain inhibition and suppresses pain facilitation and inflammation pathways.

## Abstract

This study aimed to explore the analgesic mechanism of the Rotating - Pulling - Poking Manipulation in treating acute lateral ankle sprain (ALAS). Thirty rats were randomly divided into 5 groups in the first experiment to determine the dose - effect relationship by detecting ankle pain thresholds at different time points. The results showed that the 5-min manipulation group had the best analgesic effect, with the bipedal weight - bearing difference decreasing over time and pain relief time shortened. In the second experiment, 30 rats were divided into 3 groups. After manipulation, samples from PAG and RVM were tested. The results indicated that compared with the model group, the 5-min manipulation group had increased MOR expression in PAG and 5 - HT concentration in cerebrospinal fluid, decreased expressions of BDNF, p - TrkB/TrkB in PAG and NR2A in RVM, and reduced contents of IL - 6, IL - 1β, TNF - α in ankle soft tissues. In conclusion, the Rotating - Pulling - Poking Manipulation can relieve pain by exciting the descending inhibitory system mediated by opioid receptors in the brain center, weakening the descending facilitation system mediated by the BDNF/TrkB/NR2A signaling pathway, and reducing the inflammatory response.