What question did this study set out to answer?

This study aims to evaluate the effectiveness of thoracic spine mobilization combined with physiotherapy in individuals suffering from mechanical neck pain.

July 26, 2026Open Access

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

NHNazmul HassanUniversity of Alabama at Birmingham PAParvin AkterCentre for the Rehabilitation of the Paralysed ZFZannatul FirdawsiJahangirnagar University

Key Points

This study aims to evaluate the effectiveness of thoracic spine mobilization combined with physiotherapy in individuals suffering from mechanical neck pain.
Seventy-nine participants with mechanical neck pain were randomized into trial and control groups.
Participants underwent 12 treatment sessions over 4 weeks, with assessments at baseline and post-treatment.
Outcome measures included Visual Analogue Scale (VAS), cervical range of motion (ROM), McGill pain questionnaire, and Neck Disability Index (NDI).
The trial group showed a significant reduction in VAS and NDI scores, along with increased cervical flexion ROM.
Within group analysis indicated clinically significant improvements in pain intensity, ROM, and NDI.
McGill pain characteristics were significantly reduced in both groups as per mixed analysis.

Abstract

Abstract Background Neck pain imposes a considerable burden on the healthcare system worldwide and it ranks fourth globally as the leading contributor to years lived with disability. In the United States alone, neck pain affects 30% to 50% of adults annually and persists in up to 75% of individuals even a year after initial onset of symptoms. Manual therapy with therapeutic exercises are common interventions for mechanical neck pain (MNP), but relatively few studies have investigated the effectiveness of thoracic spine mobilization (TSM) for MNP. The purpose of this study was to compare the effectiveness of TSM combined with usual physiotherapy (trial group) to usual physiotherapy only (control group). Methods Seventy-nine participants with MNP were randomized into either the trial or control groups. Treatment involved 12 sessions over 4 weeks, with a pre-assessment (baseline) and post-assessment performed. Visual Analogue Scale (VAS), cervical range of motion (ROM), McGill pain questionnaire and Neck Disability Index (NDI) were the outcome measures. Parametric tests ( independent- t ; paired- t) and non-parametric tests ( Mann Whitney- U; Wilcoxon sign ranked ) were used as appropriate for data analysis. Results The trial group demonstrated statistically significant reduction in VAS, NDI scores and increase in cervical flexion ROM. Within group analysis showed a clinically significant improvement in pain intensity, ROM and NDI. McGill pain characteristics became significantly decreased for both between and within group analysis. Conclusion The combination of upper and mid-TSM with usual physiotherapy demonstrated superior clinical outcomes ( p < 0.05) for MNP patients compared to usual physiotherapy alone. Trial registration CTRI/2020/06/026090 registered 20 June 2020, https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=43162&EncHid=11467.39474&modid=1&compid=19 .

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