Manual Techniques for the Cervicothoracic Spine: Difference between revisions

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== Introduction ==
== Introduction ==
Cervico-thoracic spine joint manipulations or mobilisations are a physiotherapy or chiropractic intervention that can be used for [[Neck Pain: Clinical Practice Guidelines|neck]], [[Lumbar Anatomy|back]] or [[shoulder]] pain.<ref name=":0">Gauri Milind Ghan & V. Sarath Babu. [https://www.tandfonline.com/doi/full/10.1080/10669817.2020.1834321?scroll=top&needAccess=true 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)</ref>


== Conditions treated ==
* 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”<ref>American Physical Therapy Association Guide to Physical Therapist Practice. Phys Ther. 2001;81:9–746. 2nd ed.</ref>.
* 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<ref>Di Fabio RP . Efficacy of manual therapy. Phys Ther.1992;72:853–864.</ref>.
* Cervico-thoracic spine joint manipulation or mobilization are a physiotherapy or chiropractic intervention that can be used for [[Neck Pain: Clinical Practice Guidelines|neck]], [[Lumbar Anatomy|back]] or [[shoulder]] pain.<ref name=":0">Gauri Milind Ghan & V. Sarath Babu. [https://www.tandfonline.com/doi/full/10.1080/10669817.2020.1834321?scroll=top&needAccess=true 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)</ref>
 
== Indications ==
 
* '''Head and neck disorders''' including:
 
# neck pain and stiffness.
# muscle-tension headache.
# migraine.


=== Neck pain ===
Some evidence has shown that grade IV cervical spine mobilisations (unilateral and central PA) can have an increase in deep neck flexor strength<ref name=":0" />.  
Some evidence has shown that grade IV cervical spine mobilisations (unilateral and central PA) can have an increase in deep neck flexor strength<ref name=":0" />.  


Thoracic mobilisations alongside deep flexor strengthening exercises have also been shown to help reduce chronic neck pain.<ref>Taesung Ko, Uichul Jeong, Kwanwoo Lee, [https://www.jstage.jst.go.jp/article/jpts/22/1/22_1_87/_article 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</ref>
Thoracic mobilisations alongside deep flexor strengthening exercises have also been shown to help reduce chronic neck pain.<ref>Taesung Ko, Uichul Jeong, Kwanwoo Lee, [https://www.jstage.jst.go.jp/article/jpts/22/1/22_1_87/_article 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</ref>


=== Thoracic pain ===
* '''Thoracic pain'''
* '''Shoulder 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<ref>S Jena, M Pattnaik, P Mohanty, [https://pdfs.semanticscholar.org/d8f2/0d3bb60fa84c6955bbc10c25760651646458.pdf 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</ref>.{{#ev:youtube|pncefI5qyog|300}}<ref>Maitland Techniques-All. Available from:  https://www.youtube.com/watch?v=pncefI5qyog</ref>{{#ev:youtube|fTKOoV5wHBU|300}}<ref>SNAGs Lower Cervical Spine C3-7 Available from: https://www.youtube.com/watch?v=fTKOoV5wHBU</ref>
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<ref>S Jena, M Pattnaik, P Mohanty, [https://pdfs.semanticscholar.org/d8f2/0d3bb60fa84c6955bbc10c25760651646458.pdf 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</ref>.{{#ev:youtube|pncefI5qyog|300}}<ref>Maitland Techniques-All. Available from:  https://www.youtube.com/watch?v=pncefI5qyog</ref>{{#ev:youtube|fTKOoV5wHBU|300}}<ref>SNAGs Lower Cervical Spine C3-7 Available from: https://www.youtube.com/watch?v=fTKOoV5wHBU</ref>


Revision as of 22:26, 9 February 2023

Original Editors - Dana Tew

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


Cervico-Thoracic Spine Joint Manipulation [edit | edit source]

Introduction[edit | edit source]

  • 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”[1].
  • 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[2].
  • Cervico-thoracic spine joint manipulation or mobilization are a physiotherapy or chiropractic intervention that can be used for neck, back or shoulder pain.[3]

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[3].

Thoracic mobilisations alongside deep flexor strengthening exercises have also been shown to help reduce chronic neck pain.[4]

  • 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[5].

[6]

[7]


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

[8]

[9]

[10]

[10]

References[edit | edit source]

  1. ↑ American Physical Therapy Association Guide to Physical Therapist Practice. Phys Ther. 2001;81:9–746. 2nd ed.
  2. ↑ Di Fabio RP . Efficacy of manual therapy. Phys Ther.1992;72:853–864.
  3. ↑ 3.0 3.1 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)
  4. ↑ 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
  5. ↑ 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
  6. ↑ Maitland Techniques-All. Available from: https://www.youtube.com/watch?v=pncefI5qyog
  7. ↑ SNAGs Lower Cervical Spine C3-7 Available from: https://www.youtube.com/watch?v=fTKOoV5wHBU
  8. ↑ Upper thoracic functional mobilization. Available from: https://www.youtube.com/watch?v=ZMThXJf6mrE
  9. ↑ Thoracic Spine mobilization. Reverse Nag. Mulligan Mobilization with movement Technique MWM. Available from: https://www.youtube.com/watch?v=A8juGfCJOcc
  10. ↑ 10.0 10.1 Mid Thoracic Spine PA Mobs. Available from: https://www.youtube.com/watch?v=-nAurCvHbuM&ab_channel=ModernManualTherapy
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