Effect of Rib Mobilization and Diaphragm Release Techniques in Patients With Non-Specific Neck Pain

MTI University

Status: Completed

Conditions: Neck Pain

Treatments: Other: Diaphragm Release Technique; Other: Rib Mobilization Technique and Diaphragm Release Technique

Study type: Interventional

Funder types: Other

Identifiers

NCT07133646

IRB # 28/7/2024-2025

Details and patient eligibility

About

Rib mobilization is a therapeutic technique aimed at enhancing the mobility of the ribcage, which can have a significant impact on neck pain, even when the pain is classified as non-specific. The ribcage plays a crucial role in maintaining the alignment and posture of the upper body, including the neck. When the ribs are restricted or misaligned, it can lead to compensatory movements and increased strain on the cervical spine, contributing to neck pain. By mobilizing the ribs, we can restore their natural movement, which in turn can release tension in the surrounding musculature and improve the overall biomechanics of the thoracic and cervical regions. This approach not only addresses the immediate symptoms of neck pain but also targets the underlying structural issues that may perpetuate discomfort.

Full description

The diaphragm is a major muscle involved in respiration, but its function extends beyond just breathing. It acts as a core stabilizer and influences the mechanics of the thoracic and cervical areas. Tension or dysfunction in the diaphragm can lead to altered breathing patterns and increased tension in the neck and shoulders, exacerbating non-specific neck pain. Releasing the diaphragm can improve respiratory efficiency and reduce undue stress on the neck. This release helps in re-establishing a more natural breathing pattern, which can alleviate pain and improve overall posture. Additionally, by addressing the diaphragm, we can indirectly affect the autonomic nervous system, promoting relaxation and reducing stress, which are often contributing factors to chronic pain syndromes.

An integrated approach that combines rib mobilization and diaphragm release can be particularly effective for managing non-specific neck pain. This method not only targets the symptoms but also addresses the root causes of neck discomfort. By improving rib and diaphragm function, we enhance the body's ability to maintain proper posture and reduce compensatory strain on the neck. This holistic treatment strategy is essential because it recognizes the interconnectedness of the body's musculoskeletal and respiratory systems. Furthermore, this approach empowers patients by providing them with a deeper understanding of their body mechanics and encouraging active participation in their rehabilitation process. Through this combination of manual therapy techniques, patients are likely to experience improved mobility, reduced pain, and a greater sense of well-being.

Enrollment: 100 patients

Sex: All

Ages: 20 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Neurological tests will be negative
• Both genders having age between 20 to 45 years
• Participants should have primary complaint of neck pain
• Neck Disability Index (NDI) score of 20% or greater (i.e. 10 points or greater on a 0 to 50 scale)
• A pain intensity of ≥4 on the 10-point Numerical Pain Rating Scale (NPRS)

Exclusion criteria

• First and second rib fracture and dislocation
• Past surgical history of cervical and thoracic region
• Thoracic Outlet syndrome and cervical radiculopathy
• Congenital anomalies of spine and ribs

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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100 participants in 3 patient groups

RMT and DRT(Rib Mobilization Technique and Diaphragm Release Technique)

Experimental group

Description:

Rib Mobilization Technique and Diaphragm Release Technique(In the seated position, the participants remained seated on the stretcher, keeping the feet on the floor, while the therapist stood in front of him or her. The participant's head (frontal region) was positioned over his or her overlapping arms, which were placed on the therapist's trunk )

Treatment:

Other: Rib Mobilization Technique and Diaphragm Release Technique

Other: Diaphragm Release Technique

DRT(Diaphragm Release Technique)

Experimental group

Description:

Diaphragm Release Technique:The DRT was performed according to the protocol described by Rocha et al.13 In this protocol, the participant remains in the supine position so that the therapist is able to maintain manual contact with the bottom edge of the rib cage

Treatment:

Other: Diaphragm Release Technique

control

No Intervention group

Description:

No intervention