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. 2015 Jan 12:11:137-44.
doi: 10.2147/NDT.S69579. eCollection 2015.

Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial

Rungthip Puntumetakul  1 , Thavatchai Suvarnnato  2 , Phurichaya Werasirirat  3 , Sureeporn Uthaikhup  4 , Junichiro Yamauchi  5 , Rose Boucaut  6
Affiliations

Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial

Rungthip Puntumetakul et al. Neuropsychiatr Dis Treat. .

Abstract

Background: Thoracic spine manipulation has become a popular alternative to local cervical manipulative therapy for mechanical neck pain. This study investigated the acute effects of single-level and multiple-level thoracic manipulations on chronic mechanical neck pain (CMNP).

Methods: Forty-eight patients with CMNP were randomly allocated to single-level thoracic manipulation (STM) at T6-T7 or multiple-level thoracic manipulation (MTM), or to a control group (prone lying). Cervical range of motion (CROM), visual analog scale (VAS), and the Thai version of the Neck Disability Index (NDI-TH) scores were measured at baseline, and at 24-hour and at 1-week follow-up.

Results: At 24-hour and 1-week follow-up, neck disability and pain levels were significantly (P<0.05) improved in the STM and MTM groups compared with the control group. CROM in flexion and left lateral flexion were increased significantly (P<0.05) in the STM group when compared with the control group at 1-week follow-up. The CROM in right rotation was increased significantly after MTM compared to the control group (P<0.05) at 24-hour follow-up. There were no statistically significant differences in neck disability, pain level at rest, and CROM between the STM and MTM groups.

Conclusion: These results suggest that both single-level and multiple-level thoracic manipulation improve neck disability, pain levels, and CROM at 24-hour and 1-week follow-up in patients with CMNP.

Keywords: neck disability; neck pain; pain level; thoracic manipulation.

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Figures

Figure 1
Figure 1
Flow diagram of subject recruitment throughout the course of the study. Abbreviation: NDI-TH, Thai version of the Neck Disability Index.
Figure 2
Figure 2
(A) Thoracic manipulation (screw thrust) (B) Segmental mobility in flexion testing and (C) Segmental mobility in extension testing.
Figure 3
Figure 3
(A) NDI-TH, baseline and after treatment; (B) pain level at rest, baseline and after treatment. Notes: aSignificant difference between baseline and 24 hours post-intervention (P<0.005) for MTM; bsignificant difference between baseline and 24 hours post-intervention (P<0.005) for STM; csignificant difference between baseline and 1 week post-intervention (P<0.005) for MTM; dsignificant difference between baseline and 1 week post-intervention (P<0.005) for STM. ♦ represents the control group, ■ represents the MTM group, and ▲ represents the STM group. Abbreviations: NDI-TH, Thai version of the Neck Disability Index; VAS, Visual Analog Scale; MTM, multiple-level thoracic manipulation; STM, single-level thoracic manipulation.
See this image and copyright information in PMC

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