Neuropsychiatr Dis Treat. 2015; 11: 137–144.
Published online 2015 Jan 12. doi: 10.2147/NDT.S69579
PMCID: PMC4296956
Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial
Rungthip Puntumetakul, Thavatchai Suvarnnato, Phurichaya Werasirirat, Sureeporn Uthaikhup, Junichiro Yamauchi, and Rose Boucaut

Abstract
Background
Thoracic spine manipulation has become a popular alternative to local cervical manipulative therapy for mechanical neck pain. This study investigated the acute effects of single-level and multiple-level thoracic manipulations on chronic mechanical neck pain (CMNP).
Methods
Forty-eight patients with CMNP were randomly allocated to single-level thoracic manipulation (STM) at T6–T7 or multiple-level thoracic manipulation (MTM), or to a control group (prone lying). Cervical range of motion (CROM), visual analog scale (VAS), and the Thai version of the Neck Disability Index (NDI-TH) scores were measured at baseline, and at 24-hour and at 1-week follow-up.
Results
At 24-hour and 1-week follow-up, neck disability and pain levels were significantly (P<0.05) improved in the STM and MTM groups compared with the control group. CROM in flexion and left lateral flexion were increased significantly (P<0.05) in the STM group when compared with the control group at 1-week follow-up. The CROM in right rotation was increased significantly after MTM compared to the control group (P<0.05) at 24-hour follow-up. There were no statistically significant differences in neck disability, pain level at rest, and CROM between the STM and MTM groups. Conclusion These results suggest that both single-level and multiple-level thoracic manipulation improve neck disability, pain levels, and CROM at 24-hour and 1-week follow-up in patients with CMNP. Full Text Article