Journal of Modern Rehabilitation 2016. 10(4):145-154.

Effectiveness of Thoracic Manipulation on the Treatment of Patients With Mechanical Non-Specific Neck Pain
Maryam Abbaszadeh-Amirdehi, Setareh Mirasi, Hadi Salehi, Gholamreza Olyaei

Abstract


Introduction: Non-specific mechanical neck pain is a common musculoskeletal complaint that is generally treated conservatively using electro/thermal therapeutic agents, exercise, soft tissue techniques, and manual therapy. In this review, we evaluated the effectiveness of Thoracic Manipulation (TM) compared to cervical manipulations, multi-level TM with single-level TM, and TM with other interventions such as electro/thermal therapy and exercise.
Material and Methods: PubMed, Google scholar and PEDro database were searched from inception until May 2016 by the following keywords: “neck pain”, “thoracic manipulation”, “physical therapy treatment”, “cervical manipulation”, and different combinations. Quality of the included studies were evaluated using physiotherapy evidence database [PEDro] scale.
Results: A total of 15 studies out of 47 based on PEDro score were included in this review. All studies measured pain intensity as a parameter indicating effectiveness of interventions, 9 studies measured disability as a key outcome and used either NDI or NPQ for its assessment.
Conclusion: Thoracic manipulation is equally effective as cervical manipulation in reduction of pain and improving function. Thoracic manipulation is also more effective than electrotherapy or exercise therapy alone. When combined with multimodal neck program, thoracic manipulation for patients with neck pain significantly improves function and reduces pain intensity.


Keywords


Non-specific neck pain, Cervical manipulation, Thoracic manipulation

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References


Khoja SS, Browder D. Benefits of thoracic Thrust Manipulation when applied with a multi-modal treatment approach in individuals with mechanical neck pain: A pilot randomized trial. International Journal of Physical Medicine & Rehabilitation. 2015; 3:306. doi: 10.4172/2329-9096.1000306

Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, et al. The burden and determinants of neck pain in workers. Spine. 2008; 33:60–74. doi: 10.1097/brs.0b013e3181643ee4

March L, Smith EUR, Hoy DG, Cross MJ, Sanchez-Riera L, Blyth F, et al. Burden of disability due to musculoskeletal (MSK) disorders. Best Practice & Research Clinical Rheumatology. 2014; 28(3):353–66. doi: 10.1016/j.berh.2014.08.002

Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, et al. The burden and determinants of neck pain in the general population. Spine. 2008; 33:39–51. doi: 10.1097/brs.0b013e31816454c8

Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: A systematic critical review of the literature. European Spine Journal. 2005; 15(6):834–48. doi: 10.1007/s00586-004-0864-4

Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, et al. Neck pain. Journal of Orthopaedic & Sports Physical Therapy. 2008; 38(9):1–34. doi: 10.2519/jospt.2008.0303

Casanova-Méndez A, Oliva-Pascual-Vaca Á, Rodriguez-Blanco C, Heredia-Rizo AM, Gogorza-Arroitaonandia K, Almazán-Campos G. Comparative short-term effects of two thoracic spinal manipulation techniques in subjects with chronic mechanical neck pain: A randomized controlled trial. Manual Therapy. 2014; 19(4):331–7. doi: 10.1016/j.math.2014.03.002

Cassou B. Chronic neck and shoulder pain, age, and working conditions: Longitudinal results from a large random sample in France. Occupational and Environmental Medicine. 2002; 59(8):537–44. doi: 10.1136/oem.59.8.537

Green BN, Dunn AS, Pearce LS, Johnson CD. Conservative management of uncomplicated mechanical neck pain in a military aviator. Journal of the Canadian Chiropractic Association. 2010; 54(2):92-9. PMCID: PMC2875906

Vernon H, Humphreys BK. Manual therapy for neck pain: An overview of randomized clinical trials and systematic reviews. Europa Medicophysica. 2007; 43(1):91-118. PMID: 17369783

Brown K, Luszeck T, Nerdin S, Yaden J, Young JL. The effectiveness of cervical versus thoracic Thrust Manipulation for the improvement of pain, disability, and range of motion in patients with mechanical neck pain. Physical Therapy Reviews. 2014; 19(6):381–91. doi: 10.1179/1743288x14y.0000000155

Carlesso LC, MacDermid JC, Gross AR, Walton DM, Santaguida P. Treatment preferences amongst physical therapists and chiropractors for the management of neck pain: Results of an international survey. Chiropractic & Manual Therapies. 2014; 22(1):11. doi: 10.1186/2045-709x-22-11

Gross A, Miller J, D’Sylva J, Burnie SJ, Goldsmith CH, Graham N, et al. Manipulation or mobilisation for neck pain: A Cochrane Review. Manual Therapy. 2010; 15(4):315–33. doi: 10.1016/j.math.2010.04.002

Leaver AM, Maher CG, Herbert RD, Latimer J, McAuley JH, Jull G, et al. A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain. Archives of Physical Medicine and Rehabilitation. 2010; 91(9):1313-8. doi: 10.1016/j.apmr.2010.06.006.

Vincent K, Maigne J-Y, Fischhoff C, Lanlo O, Dagenais S. Systematic review of manual therapies for nonspecific neck pain. Joint Bone Spine. 2013; 80(5):508–15. doi: 10.1016/j.jbspin.2012.10.006

Griswold D, Learman K, O’Halloran B, Cleland J. A preliminary study comparing the use of cervical/upper thoracic mobilization and manipulation for individuals with mechanical neck pain. Journal of Manual & Manipulative Therapy. 2014; 23(2):75–83. doi: 10.1179/2042618614y.0000000095

Dunning JR, Cleland JA, Waldrop MA, Arnot C, Young I, Turner M, et al. Upper cervical and upper thoracic Thrust Manipulation versus nonthrust mobilization in patients with mechanical neck pain: A multicenter randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2012; 42(1):5–18. doi: 10.2519/jospt.2012.3894

Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy. 2009; 14(5):531–8. doi: 10.1016/j.math.2008.09.001

Gal J, Herzog W, Kawchuk G, Conway PJ, Zhang YT. Movements of vertebrae during manipulative thrusts to unembalmed human cadavers. Journal of Manipulative and Physiological Therapeutics. 1997; 20(1):30-40. PMID: 9004120

Colloca CJ, Keller TS, Harrison DE, Moore RJ, Gunzburg R, Harrison DD. Spinal manipulation force and duration affect vertebral movement and neuromuscular responses. Clinical Biomechanics. 2006; 21(3):254–62. doi: 10.1016/j.clinbiomech.2005.10.006

Pickar JG. Neurophysiological effects of spinal manipulation. The Spine Journal. 2002; 2(5):357–71. doi: 10.1016/s1529-9430(02)00400-x

Hegedus EJ, Goode A, Butler RJ, Slaven E. The neurophysiological effects of a single session of spinal joint mobilization: Does the effect last. Journal of Manual & Manipulative Therapy. 2011; 19(3):143–51. doi: 10.1179/2042618611y.0000000003

Teodorczyk-Injeyan JA, Injeyan HS, Ruegg R. Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. Journal of Manipulative and Physiological Therapeutics. 2006; 29(1):14–21. doi: 10.1016/j.jmpt.2005.10.002

Bishop MD, Mintken P, Bialosky JE, Cleland JA. Patient expectations of benefit from interventions for neck pain and resulting influence on outcomes. Journal of Orthopaedic & Sports Physical Therapy. 2013; 43(7):457–65. doi: 10.2519/jospt.2013.4492

Benz LN, Flynn TW. Placebo, nocebo, and expectations: Leveraging positive outcomes. Journal of Orthopaedic & Sports Physical Therapy. 2013; 43(7):439–41. doi: 10.2519/jospt.2013.0105

Dunning JR, Butts R, Mourad F, Young I, Fernandez-de-las Peñas C, Hagins M, et al. Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: A multi-center randomized clinical trial. BMC Musculoskeletal Disorders. 2016; 17:64. doi: 10.1186/s12891-016-0912-3

Puentedura EJ, Landers MR, Cleland JA, Mintken P, Huijbregts P, Fernandez-De-Las-Peñas C. Thoracic spine Thrust Manipulation versus cervical spine Thrust Manipulation in patients with acute neck pain: A randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2011; 41(4):208–20. doi: 10.2519/jospt.2011.3640

Saavedra-Hernández M, Arroyo-Morales M, Cantarero-Villanueva I, Fernández-Lao C, Castro-Sánchez AM, Puentedura EJ, et al. Short-term effects of spinal thrust joint manipulation in patients with chronic neck pain: A randomized clinical trial. Clinical Rehabilitation. 2013; 27(6):504–12. doi: 10.1177/0269215512464501

Martínez-Segura R, Fernández-de-las-Peñas C, Ruiz-Sáez M, López-Jiménez C, Rodríguez-Blanco C. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: A randomized controlled trial. Journal of Manipulative and Physiological Therapeutics. 2006; 29(7):511–7. doi: 10.1016/j.jmpt.2006.06.022

Saavedra-Hernández M, Castro-Sánchez AM, Arroyo-Morales M, Cleland JA, Lara-Palomo IC, Fernández-de-las-Peñas C. Short-term effects of kinesio taping versus cervical Thrust Manipulation in patients with mechanical neck pain: A randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2012; 42(8):724–30. doi: 10.2519/jospt.2012.4086

Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, et al. Risk of vertebrobasilar stroke and chiropractic care. European Spine Journal. 2008; 17(1):176–83. doi: 10.1007/s00586-008-0634-9

Rothwell DM, Bondy SJ, Williams JI, Bousser M-G. Chiropractic manipulation and stroke: A population-based case-control study. Stroke. 2001; 32(5):1054–60. doi: 10.1161/01.str.32.5.1054

Smith WS, Johnston SC, Skalabrin EJ, Weaver M, Azari P, Albers GW, et al. Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology. 2003; 60(9):1424–8. doi: 10.1212/01.wnl.0000063305.61050.e6

Miley ML, Wellik KE, Wingerchuk DM, Demaerschalk BM. Does cervical manipulative therapy cause vertebral artery dissection and stroke. The Neurologist. 2008; 14(1):66–73. doi: 10.1097/nrl.0b013e318164e53d

Di Fabio RP. Manipulation of the cervical spine: Risks and benefits. Physical Therapy. 1999; 79(1):50-65. PMID: 9920191

Ernst E. Adverse effects of spinal manipulation: A systematic review. Journal of the Royal Society of Medicine. 2007; 100(7):330–8. doi: 10.1258/jrsm.100.7.330

Langenfeld A, Humphreys BK, de Bie RA, Swanenburg J. Effect of manual versus mechanically assisted manipulations of the thoracic spine in neck pain patients: study protocol of a randomized controlled trial. Trials. 2015; 16(1). doi: 10.1186/s13063-015-0763-5

Herbert R, Moseley A, Sherrington C, Maher C. Physiotherapy evidence database. Physiotherapy. 2000; 86(1):55. doi: 10.1016/S0031-9406(05)61357-0

Walser RF, Meserve BB, Boucher TR. The effectiveness of thoracic spine manipulation for the management of musculoskeletal conditions: A systematic review and meta-analysis of randomized clinical trials. Journal of Manual & Manipulative Therapy. 2009; 17(4):237–46. doi: 10.1179/106698109791352085

Lee KW, Kim WH. Effect of thoracic manipulation and deep craniocervical flexor training on pain, mobility, strength, and disability of the neck of patients with chronic nonspecific neck pain: A randomized clinical trial. Journal of Physical Therapy Science. 2016; 28(1):175–80. doi: 10.1589/jpts.28.175

Puntumetakul R, Suvarnnato T, Werasirirat P, Uthaikhup S, Yamauchi J, Boucaut R. Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial. Neuropsychiatric Disease and Treatment. 2015; 11:137-44. doi: 10.2147/ndt.s69579

Yang J, Lee B, Kim C. Changes in proprioception and pain in patients with neck pain after upper thoracic manipulation. Journal of Physical Therapy Science. 2015; 27(3):795–8. doi: 10.1589/jpts.27.795

Pires PF, Packer AC, Dibai-Filho AV, Rodrigues-Bigaton D. Immediate and short-term effects of upper thoracic manipulation on myoelectric activity of sternocleidomastoid muscles in young women with chronic neck pain: A randomized blind clinical trial. Journal of Manipulative and Physiological Therapeutics. 2015; 38(8):555–63. doi: 10.1016/j.jmpt.2015.06.016

Salom-Moreno J, Ortega-Santiago R, Cleland JA, Palacios-Ceña M, Truyols-Domínguez S, Fernández-de-las-Peñas C. Immediate changes in neck pain intensity and widespread pressure pain sensitivity in patients with bilateral chronic mechanical neck pain: A randomized controlled trial of thoracic Thrust Manipulation vs non–thrust mobilization. Journal of Manipulative and Physiological Therapeutics. 2014; 37(5):312–9. doi: 10.1016/j.jmpt.2014.03.003

Martínez-Segura R, de-la-Llave-Rincón AI, Ortega-Santiago R, Cleland JA, Fernández-de-las-Peñas C. Immediate changes in widespread pressure pain sensitivity, neck pain, and cervical range of motion after cervical or thoracic Thrust Manipulation in patients with bilateral chronic mechanical neck pain: A randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2012; 42(9):806–14. doi: 10.2519/jospt.2012.4151

Lau HMC, Wing Chiu TT, Lam TH. The effectiveness of thoracic manipulation on patients with chronic mechanical neck pain – A randomized controlled trial. Manual Therapy. 2011; 16(2):141–7. doi: 10.1016/j.math.2010.08.003

Cleland JA, Mintken PE, Carpenter K, Fritz JM, Glynn P, Whitman J, et al. Examination of a clinical prediction rule to identify patients with neck pain likely to benefit from thoracic spine Thrust Manipulation and a general cervical range of motion exercise: Multi-center randomized clinical trial. Physical Therapy. 2010; 90(9):1239–50. doi: 10.2522/ptj.20100123

González-Iglesias J, Fernández-de-las-Peñas C, Cleland JA, Alburquerque-Sendín F, Palomeque-del-Cerro L, Méndez-Sánchez R. Inclusion of thoracic spine Thrust Manipulation into an electro-therapy/thermal program for the management of patients with acute mechanical neck pain: A randomized clinical trial. Manual Therapy. 2009; 14(3):306–13. doi: 10.1016/j.math.2008.04.006

González-Iglesias J, Fernández-de-las-Peñas C, Cleland JA, del Rosario Gutiérrez-Vega M. Thoracic spine manipulation for the management of patients with neck pain: A randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2009; 39(1):20–7. doi: 10.2519/jospt.2009.2914

Cleland JA, Glynn P, Whitman JM, Eberhart SL, MacDonald C, Childs JD. Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain: A randomized clinical trial. Physical Therapy. 2007; 87(4):431–40. doi: 10.2522/ptj.20060217

Cleland JA, Childs MJD, McRae M, Palmer JA, Stowell T. Immediate effects of thoracic manipulation in patients with neck pain: A randomized clinical trial. Manual Therapy. 2005; 10(2):127–35. doi: 10.1016/j.math.2004.08.005

Cross KM, Kuenze C, Grindstaff T, Hertel J. Thoracic spine Thrust Manipulation improves pain, range of motion, and self-reported function in patients with mechanical neck pain: A systematic review. Journal of Orthopaedic & Sports Physical Therapy. 2011; 41(9):633–42. doi: 10.2519/jospt.2011.3670

Ssavedra-Hernández M, Castro-Sánchez AM, Fernández-de-las-Peñas C, Cleland JA, Ortega-Santiago R, Arroyo-Morales M. Predictors for identifying patients with mechanical neck pain who are likely to achieve short-term success with manipulative interventions directed at the cervical and thoracic spine. Journal of Manipulative and Physiological Therapeutics. 2011; 34(3):144–52. doi: 10.1016/j.jmpt.2011.02.011

Suvarnnato T, Puntumetakul R, Kaber D, Boucaut R, Boonphakob Y, Arayawichanon P, et al. The effects of thoracic manipulation versus mobilization for chronic neck pain: A randomized controlled trial pilot study. Journal of Physical Therapy Science. 2013; 25(7):865–71. doi: 10.1589/jpts.25.865

Fernández-de-las-Peñas C, Palomeque-del-Cerro L, Rodríguez-Blanco C, Gómez-Conesa A, Miangolarra-Page JC. Changes in neck pain and active range of motion after a single thoracic spine manipulation in subjects presenting with mechanical neck pain: A case series. Journal of Manipulative and Physiological Therapeutics. 2007; 30(4):312–20. doi: 10.1016/j.jmpt.2007.03.007

Haldeman S, Kohlbeck FJ, McGregor M. Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy. Spine. 2002; 27(1):49–55. doi: 10.1097/00007632-200201010-00012


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