Manual Techniques for the Cervicothoracic Spine

Original Editors - Dana Tew

Top Contributors - Kim Jackson, Mariam Hashem, Abbey Wright, Dana Tew, Aya Alhindi and Samuel Winter


Introduction[edit | edit source]

Cervico-thoracic spine joint manipulations or mobilisations are aN intervention that can be used for neck, back, or shoulder pain.[1]

  • The Guide to Physical Therapist Practice defines mobilization/manipulation as “skilled passive movements to joints and/or related soft tissue that are applied at varying speeds and amplitudes, including small-amplitude/high-velocity therapeutic movements”[2].
  • Manipulation of the spine (MTS)can also be defined as a form of manual therapy that is used in an effort to reduce pain and improve range of motion[3].
  • Cervico-thoracic spine joint manipulation or mobilization are a physiotherapy or chiropractic intervention that can be used for neck, back or shoulder pain.[4]

Indications[edit | edit source]

  • Head and neck disorders including:
  1. neck pain and stiffness.
  2. muscle-tension headache.
  3. migraine.

Some evidence has shown that grade IV cervical spine mobilisations (unilateral and central PA) can have an increase in deep neck flexor strength[4].

Thoracic mobilisations alongside deep flexor strengthening exercises have also been shown to help reduce chronic neck pain.[5]

  • Thoracic pain
  • Shoulder pain

Some studies have shown that cervical and thoracic joint mobilisations can help to reduce pain and improve ROM in some patients presenting with sub-acromial pain syndrome[6].

[7]

[8]


Thoracic Spine Joint Manipulation and Mobilization[edit | edit source]

[9]

[10]

[11]

[11]

References[edit | edit source]

  1. Ghan GM, Babu VS. Immediate effect of cervico-thoracic mobilization on deep neck flexors strength in individuals with forward head posture: A randomized controlled trial. Journal of Manual & Manipulative Therapy. 2021 May 4;29(3):147-57.
  2. American Physical Therapy Association Guide to Physical Therapist Practice. Phys Ther. 2001;81:9–746. 2nd ed.
  3. Di Fabio RP . Efficacy of manual therapy. Phys Ther.1992;72:853–864.
  4. 4.0 4.1 Gauri Milind Ghan & V. Sarath Babu. Immediate Effect of Cervico-thoracic Mobilization on Deep Neck Flexors Strength in Individuals with Forward Head Posture: A Randomized Controlled Trial, Journal of Manual & Manipulative Therapy, (2020)
  5. Taesung Ko, Uichul Jeong, Kwanwoo Lee, Effects of the Inclusion Thoracic Mobilization into Cranio-Cervical Flexor Exercise in Patients with Chronic Neck Pain, Journal of Physical Therapy Science, 2010, Volume 22, Issue 1, Pages 87-91
  6. S Jena, M Pattnaik, P Mohanty, Effect of cervico-thoracic mobilisation on hemiplegic shoulder pain with supraspinatus tendonitis due to impingement syndrome: an experimental study. International Journal of Physiotherapy and Research, Int J Physiother Res 2016, Vol 4(3):1510-17
  7. Maitland Techniques-All. Available from: https://www.youtube.com/watch?v=pncefI5qyog
  8. SNAGs Lower Cervical Spine C3-7 Available from: https://www.youtube.com/watch?v=fTKOoV5wHBU
  9. Upper thoracic functional mobilization. Available from: https://www.youtube.com/watch?v=ZMThXJf6mrE
  10. Thoracic Spine mobilization. Reverse Nag. Mulligan Mobilization with movement Technique MWM. Available from: https://www.youtube.com/watch?v=A8juGfCJOcc
  11. 11.0 11.1 Mid Thoracic Spine PA Mobs. Available from: https://www.youtube.com/watch?v=-nAurCvHbuM&ab_channel=ModernManualTherapy