Effectiveness of upper and mid thoracic spine mobilization in individuals with mechanical neck pain: a randomized trial

Abstract

Background: Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences. Although cervical mobilization plus therapeutic exercises are common interventions for the management of mechanical neck pain, no study has directly compared the effectiveness of upper thoracic spine mobilization and conventional care with that of conventional care alone in individuals with Mechanical Neck Pain. Objective: Methods: Seventy-Nine participants with Mechanical Neck Pain were randomized into the cervical group or the thoracic group. The treatment period was 4 weeks comprising 12 sessions pre & post assessment. Outcome measures including the pain (VAS- Visual Analogue Scale), cervical range of motion (Goniometer), McGill Pain Questionnaire & neck disability index (NDI) were collected. Data were analyzed with Independent ‘t’ test, Paired ‘t’ test as parametric test; Mann-Whitney ‘U’ test and Wilcoxon Sign Ranked Test as non-parametric test. Results: Participants in the trial group demonstrated significant improvements (p < .05) in Pain, cervical extension, and NDI at the unpaired ‘t’ test compared with those in the control group. In addition, control group participants in the trial group compared with the control group showed a significant improvement in McGill Pain Characteristics. Conclusions: The combination of upper thoracic spine mobilization and conventional physiotherapy demonstrated better overall short-term outcomes in Pain, cervical extension, McGill Pain Characteristics, and NDI compared with the control. Trial registration: CTRI/2020/06/026090 [Registered on: 24/06/2020] - Trial Registered Retrospectively Keywords: Mobilization, Upper & mid-thoracic spine mobilization, Conventional Care, Mechanical Neck pain.