Effectiveness of upper thoracic (T1-T4) manipulation (T.M) combined with usual care among patients with chronic mechanical neck pain: randomized controlled trial (RCT)

Abstract

Background: Neck pain is a debilitating condition that may greatly affect quality of life. The prevalence is 0.4% to 86.8% worldwide in general population. It is more frequent in women than men and increases particularly among people of working age & over 33% of neck pain patients develop chronic in nature that means last for at least 3 months. Objectives: To determine and compare patient rated general neck pain, neck ROM, neck disability and CV angle before and after application TM combined with usual care among patients with CNP. Methodology: Classic experimental study design was used in this study. 40 patients with CNP were randomly assigned into two groups from outdoor musculo-skeletal unit, CRP-Dhaka. Among them 20 patients were assigned into trial group received TM with usual care and another 20 into control group received only usual care. Total treatment sessions were eight comprising of 2 sessions per week for 4 weeks. Single blinding procedure was used during data collection. Outcome measurement tools: Numerical pain rating scale (NPRS) was used to measure pain and universal goniometer to measure ROM, CV angle measure by tape and NDI to measure neck disability. Analysis of data: Inferential statistics such as Mann-Whitney U test, Paired t and Wilcoxon test was done using SPSS version 25. Results: Patients that received TM showed significantly greater improvement in pain intensity (P = 0.05), CV angle (P= 0.05), NDI (P= 0.000), neck flexion (P=0.05) and neck side flexion both right & left (p=0.05) than the control group immediately post-intervention. Conclusion: This study shows that TM was effective in reducing neck pain, improving dysfunction and range of motion (ROM) for patients with chronic mechanical neck pain. Key words: Chronic neck pain, Thoracic Manipulation, and Usual care.