Thoracic Spine Manipulation on Pressure Pain Sensitivity of Active Myofascial Trigger Points in Rhomboid Muscle

Effects of Thoracic Spine Manipulation on Pressure Pain Sensitivity of Active Myofascial Trigger Points in Rhomboid Muscle

This study intends to determine the effects of thoracic manipulation on pressure pain sensitivity in patients with rhomboid active trigger points.

This is a single blinded controlled trial and will be conducted at physiotherapy clinic of women institute of rehabilitation sciences Abbottabad. The "screw" manipulation is a fairly aggressive manipulative technique in which the transverse processes are forced into a posterior to anterior direction Individual will be screened out according to inclusion criteria. Individuals will be allocated randomly into two groups, 30 in thoracic manipulation group and 30 in conventional physiotherapy protocol group by sealed envelope method. Both groups will receive conventional physiotherapy protocol (manual pressure release technique and muscle imbalances exercises) for rhomboid trigger points in common and the experimental group will receive thoracic manipulation in addition to conventional protocol.

Assessment will be done on baseline and after 3 weeks. Data will be analyzed on SPSS version 21.

Inclusion Criteria:

• Age between 18 to 30 years
• Participants presented with interscapular pain
• Forward head posture with active trigger points in rhomboid muscle
• Segmental hypomobility in upper thoracic identified with positive springing test

Exclusion Criteria:

• Participants who demonstrated contraindication to manipulation
• Open wounds or Trauma to the area which occurred less than two months prior treatment
• Any neurological compromise
• Mid scapular pain due to degenerative process or osteoporosis