Thoracic manipulation versus mobilization in patients with mechanical neck pain

Thoracic manipulation is applied frequently in physical therapy and has been shown to be effective at addressing mechanical neck pain. However, thoracic mobilization may yield similar effects. The authors therefore conducted this systematic review with the goal of evaluating the current literature regarding the effectiveness of thoracic manipulation versus mobilization in patients with mechanical neck pain. ProQuest, NCBI-PubMed, APTA’s Hooked on Evidence, Cochrane Library, CINAHL and SPORTDiscus were searched to identify relevant studies. Fourteen studies meeting the inclusion criteria were analyzed using the Physiotherapy Evidence Database (PEDro) scale and the GRADE approach. The literature as assessed by the PEDro scale was fair and the GRADE method showed overall quality ranging from very low to moderate quality. The 14 included studies showed positive outcomes on cervical pain levels, range of motion, and/or disability with the use of thoracic manipulation or mobilization. There was a lack of literature directly comparing thoracic manipulation and mobilization.

Current limitations in the body of research, specifically regarding the use of thoracic mobilization, limit the recommendation of its use compared to thoracic manipulation for patients with mechanical neck pain. The authors added, though, that there was a significant amount of evidence, although of varied quality, for the short-term benefits of thoracic manipulation in treating individuals with this condition. They concluded that additional high quality research is needed to determine which technique is more effective in treating patients with mechanical neck pain.