Mechanical neck pain (MNP) is characterized as neck discomfort mostly originating from musculoskeletal components such as cervical facet joints, intervertebral discs, ligaments, and musculature, in the absence of indications of nerve root compression or severe pathological conditions. Although recent evidence supports the use of both cervical and thoracic mobilization for mechanical neck pain, there remains limited comparative research examining their combined or relative effects on pain, functional disability, and quality of life. A total of 66 Participants with mechanical neck pain (> 4 weeks) will be randomly allocated into two groups: Group A (Cervical spine Maitland mobilization group) will receive cervical spine Maitland mobilization throughout the 8-week intervention period, with sessions conducted twice weekly from pre-treatment to post-treatment assessment, Each session will be lasted approximately 30 minutes, consisting of manual therapy followed by standardized therapeutic exercises, supervised exercises will be performed for approximately 15 minutes. Additionally, participants in both groups will be prescribed a daily home exercise program lasting 10-15 minutes. Group B (Thoracic Plus Cervical Spine Maitland Mobilization) will receive combined thoracic and cervical spine Maitland mobilization, Thoracic mobilization will be applied to the upper thoracic segments (T1-T4) using central PA Technique. Grades III and IV mobilizations for thoracic stiffness and restore extension mobility, while lower grades will be applied in cases of increased pain sensitivity. Thoracic mobilization will be delivered for approximately 6-8 minutes, after that cervical mobilization with same protocol of supervised exercise and home pan for mechanical neck pain will be used. Each treatment session will be lasted approximately 30 minutes. Outcome measures will include: Pain intensity assessed using the Visual Analogue Scale (VAS) Functional disability will be evaluated using the Neck Disability Index (NDI), Health-related quality of life will be measured using the Short Form-36 (SF-36). The primary objective of this study is to evaluate the effects of cervical spine mobilization and thoracic spine mobilization on pain intensity, functional disability, and quality of life in patients with mechanical neck pain.
Inclusion Criteria:
Participants of both genders aged between 20 and 40 years with a clinical diagnosis of mechanical neck pain will be included in the study. Eligible participants must have a history of neck pain lasting more than 4 weeks (subacute to chronic) and demonstrate mild to moderate functional disability, defined by a Neck Disability Index (NDI) score between 10% and 50%.
Exclusion Criteria:
Participants will be excluded if they present with signs or symptoms of cervical radiculopathy or myelopathy, such as a positive Spurling's test accompanied by neurological deficits, dermatomal numbness, or myotome weakness. Individuals with a history of cervical spine fracture, dislocation, or spinal surgery, as well as those with inflammatory, infectious, or neoplastic spinal conditions, will also be excluded. Additional exclusion criteria include diagnosed osteoporosis or prolonged use of systemic corticosteroids, severe cervical spine instability or vertebrobasilar insufficiency, recent trauma to the cervical or thoracic spine within the past 6 months, presence of systemic neurological disorders, pregnancy, and current participation in another physiotherapy or clinical trial for neck pain.
muhammad.tariq@ubas.edu.pk+923454190056
Participants in this group will receive cervical spine Maitland mobilization along with standardized physiotherapy care, including patient education on posture, ergonomics, and a structured home exercise program. The intervention will be conducted for 8 weeks, with 2 sessions per week, each lasting approximately 30 minutes. Cervical mobilization will be applied to symptomatic segments (C2-C7) using graded oscillatory techniques to reduce pain and improve cervical mobility
Participants in this group will receive combined thoracic and cervical spine Maitland mobilization along with standardized physiotherapy care, including posture education and a structured home exercise program. The intervention will be conducted for 8 weeks, with 2 sessions per week, each lasting approximately 30 minutes. Thoracic mobilization will be applied to improve thoracic mobility, followed by cervical mobilization to reduce pain and enhance function.
Mianahmadarshad3@gmail.com+923018822967
Comparison of the Effectiveness of Mobilization and Manipulation of the Thoracic Spine in Patients With Mechanical Neck Pain
Effects of Maitland's Antero-Posterior Versus Lateral Mobilizations on Cardiovascular Responses
Clinical Outcomes of Maitland's Mobilization in Patients With Myofacial Chronic Neck Pain
The Effect of Scapulothoracic Mobilization on Cervical Pain and Range of Motion in Patients With Neck Pain and Scapular Dyskinesia
Cervical and Upper Thoracic Mobilization and Manipulation for Mechanical Neck Pain
The Effects of Thoracic Spine Mobilizations in Individuals With Neck Pain.
Cervical Mobilization vs. Standard Physical Therapy for Chronic Neck Pain
Cervicothoracic Junction Mobilization Versus Muscle Energy Technique in Chronic Neck Pain