The authors conducted this study to compare the effects of an isolated application of cervical spine thrust joint manipulation vs. the application of cervical, cervico-thoracic junction and thoracic manipulation on neck pain, disability and cervical range of motion in chronic neck pain. They used a randomized clinical trial of eighty-two patients (41 females) with chronic mechanical neck pain at a clinical practice. Patients were put at random into a cervical spine manipulation group or a full manipulative group who received mid-cervical, cervico-thoracic and thoracic joint manipulations. Measurements used consisted of neck pain severity (11-point numeric pain rating scale), self-reported disability (Neck Disability Index) and cervical range of motion, collected at baseline and one week post intervention by an assessor blinded to the allocation of the patients. A substantial Group * Time interaction for Neck Disability Index (P = 0.022), but not for neck pain (P = 0.612), was found: patients in the full manipulative group showed more reduction in disability than those who received the cervical spine manipulation on its own, whereas both groups experienced similar decreases in neck pain. Patients in both groups experienced similar increases in cervical range of motion (P > 0.4). No effect of gender was observed (P > 0.299).
The study concluded that in patients with chronic mechanical neck pain, manipulation of the cervical and thoracic spine leads to a increased reduction in disability at one week than after manipulation of the cervical spine alone, while changes in pain and range of motion are not affected differently.