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In this context, chiropractic care provides a safe and effective option for the management of a large proportion of these patients. Chiropractic is a healthcare profession mainly focused on the spine and the treatment of spinal disorders, including spine pain. Basic studies have examined the influence of chiropractic spinal manipulation (SM) on a variety of peripheral, spinal and supraspinal mechanisms involved in spine pain. While spinal cord mechanisms of pain inhibition contribute at least partly to the pain\u2010relieving effects of chiropractic treatments, the evidence is weaker regarding peripheral and supraspinal mechanisms, which are important components of acute and chronic pain. This narrative review highlights the most relevant mechanisms of pain relief by SM and provides a perspective for future research on SM and spine pain, including the validation of placebo interventions that control for placebo effects and other non\u2010specific effects that may be induced by SM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Spinal manipulation inhibits back and neck pain partly through spinal segmental mechanisms and potentially through peripheral mechanisms regulating inflammatory responses. Other mechanisms remain to be clarified. Controls and placebo interventions need to be improved in order to clarify the contribution of specific and non\u2010specific effects to pain relief by spinal manipulative therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1773","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T08:40:56Z","timestamp":1617180056000},"page":"1429-1448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Neurophysiological mechanisms of chiropractic spinal manipulation for spine pain"],"prefix":"10.1002","volume":"25","author":[{"given":"Carlos","family":"Gevers\u2010Montoro","sequence":"first","affiliation":[{"name":"Department of Anatomy Universit\u00e9 du Qu\u00e9bec \u00e0 Trois\u2010Rivi\u00e8res Trois\u2010Rivi\u00e8res QC Canada"},{"name":"CogNAC Research Group Universit\u00e9 du Qu\u00e9bec \u00e0 Trois\u2010Rivi\u00e8res Trois\u2010Rivi\u00e8res QC Canada"},{"name":"Madrid College of 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