The paper by Tobbackx et al., entitled 'Does acupuncture activate endogenous analgesia in chronic whiplash associated disorders? A randomized cross-over trial' (Tobbackx et al., 2012) in this issue examines the effects of acupuncture on symptoms related to cervical acceleration-decelaration injuries. The authors applied a refined methodology to introduce measures that allowed different aspects of the endogenous pain-modulating network to be distinguished. According to Wall and Melzack, (noxious) stimuli can lead to opioid-mediated analgesic effects (Wall and Melzack, 2002), especially via the so-called diffuse noxious inhibitory control (DNIC) network (Le Bars et al., 1979a,b). In order to test this hypothesis, Tobbackx et al. used both local pressure pain and temporal summation of pressure pain stimuli applied to the subjects' neck and calf as a model of conditioned pain modulation. Examinations were performed without and after inflation of an occlusive cuff around the subjects' arm.
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