Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: A randomized controlled trial

J Back Musculoskelet Rehabil. 2021;34(5):735-743. doi: 10.3233/BMR-191798.


Background: Performing thoracic manipulations for neck pain can result in immediate improvements in neck function.

Objective: The aim of this study was to investigate the immediate effects of thoracic manipulation on cervical joint position sense and cervical range of motion in individuals with chronic mechanical neck pain.

Methods: Eighty male volunteers between 18-25 years and having chronic or recurrent neck or shoulder pain of at least 3 months duration with or without arm pain were randomized into two groups: Thoracic Manipulation Group (TMG:50) and Control Group (CG:30), with a pretest-posttest experimental design. The TMG was treated with thoracic extension manipulation while the CG received no intervention. Cervical joint position error and cervical range of motion of the individuals were assessed at baseline and 5 minutes later.

Results: There was no difference in demographic variables such as age (p= 0.764), Body Mass Index (p= 0.917) and Neck Pain Disability Scale (NPDS) scores (p= 0.436) at baseline outcomes between TMG and CGs. Joint position error outcomes between the two groups following intervention were similar in all directions at 30 and 50 degrees. Differences in range of motion following intervention in neck flexion (p< 0.001) and right rotation (p= 0.004) were higher in TMG compared to CG.

Conclusions: A single session of thoracic manipulation seems to be inefficient on joint position sense in individuals with mild mechanical neck pain. However, thoracic manipulation might be an effective option to increase flexion and rotation of the cervical region as an adjunctive to treatment.

Keywords: Spinal manipulation; injuries; manipulative therapies; neck.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cervical Vertebrae
  • Humans
  • Male
  • Manipulation, Spinal*
  • Neck Pain* / therapy
  • Pain Measurement
  • Proprioception
  • Range of Motion, Articular
  • Thoracic Vertebrae
  • Treatment Outcome