Comparing manual and mechanically assisted manipulations of the thoracic spine in neck pain patients: A pilot study

Abstract

Background: Manipulations of the thoracic spine are a common treatment option in patients with neck pain. This approach avoids the risk of cervical arterial dissection. Currently there are different options available which have been evaluated for their efficacy. The aim of this study was to assess short- and long-term effects of two different methods of manipulating the thoracic spine in combination with a standardized exercise program for neck pain. Methods: This pilot study included patients who were over 18 years of age, able to speak and read German or English, had acute or chronic neck pain, and had not previously undergone manual therapy for the thoracic spine. Patients were recruited from private physical therapy practices. Patients were randomly assigned to two treatment groups by using block randomization. The objective was to compare the effects of manually performed manipulations and electromechanical manipulations on the thoracic spine in patients with neck pain. Primary outcome was the visual analogue pain rating scale. Secondary outcomes included Neck Disability Index, European Quality of Life scale, and Patients’ Global Impression of Change Scale. Results: Ten patients were recruited. Five patients received manual manipulations, and five received electromechanical manipulations. Both groups showed an improvement in pain scores (VAS) (X2 (5) = 14.161, p = 0.015) with no difference between the groups. There were no significant changes in the secondary outcomes. The electromechanical (Impulse iQ®) manipulations group showed a clinically relevant reduction in the neck disability index. Conclusion: Both manual and electromechanical manipulations are well tolerated, and show that they can be both successful treatments for neck pain in combination with exercises. Thoracic manipulations seem to be beneficial for the patient’s complaint of neck pain, while electromechanical manipulations seem to be able to reduce neck disability. Trial registration: Current Controlled Trials ISRCTN88585962, registered in January 2013.