Effects of Thoracic Spine Manipulation With and Without Costovertebral Joint Manipulation in Patients Mid-back Pain

Riphah International University

Status: Not yet enrolling

Conditions: Back Pain

Treatments: Other: thoracic facet and costovertebral manipulations; Other: thoracic facet manipulations

Study type: Interventional

Funder types: Other

Identifiers

NCT07063992

REC/RCR &AHS/24/0142 Alishah

Details and patient eligibility

About

Mid-back pain (mbp) is defined as pain occurring within the limits of the third thoracic (T3) and ninth thoracic (T9) vertebrae, caused by the dysfunction of the musculoskeletal structures in the thoracic spine. It can present as pain and/or burning between the shoulder blades with reduced thoracic spine mobility and increased muscle tension. Congenital disorders such as scoliosis and Scheuermann's disease, or acquired disorders such as thoracic facet and costovertebral joint dysfunction may cause mid back pain.

Full description

Participants aged 18-45 years with non-specific mid-back pain will be randomly assigned to receive either thoracic spine manipulation alone or in combination with costovertebral joint manipulation. Primary outcomes will include pain intensity measured by the Numeric Pain Rating Scale (NPRS), while secondary outcomes will involve thoracic spine range of motion measured by Bubble Inclinometer, and functional disability assessed by the Oswestry Disability Index (ODI). Statistical analysis will be performed using the statistical software IBM SPSS Statistics SPSS 25.0 for calculations. This study aims to provide evidence-based insights into the relative benefits of these manual therapy techniques, potentially informing clinical practice and enhancing treatment outcomes for patients with non-specific mid-back pain.

Enrollment: 34 estimated patients

Sex: All

Ages: 18 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Participants will be between 18 - 45 years of age
• For this study, mid-back pain included all the following signs and symptoms:
• Sharp, shooting, or aching mid-back pain
• Mid back pain experienced during deep inspiration, sneezing, and/or coughing

Exclusion criteria

• Individuals who did not sign or understand the letter of informed consent
• Individuals with contraindications to manipulation in the thoracic spine (15)
• Weakened bone due to: Osteoporosis, Infection and Neoplasm

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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34 participants in 2 patient groups

thoracic facet manipulations

Experimental group

Description:

Group A will receive thoracic facet manipulations of the restricted segments between T3 to T9, in the prone position and cephalic direction. The duration of the intervention will be followed by 4 weeks 3 sessions each week and pre- and post-intervention observations will be recorded. * Bilateral hypothenar * Cross bilateral hypothenar manipulation

Treatment:

Other: thoracic facet manipulations

thoracic facet and costovertebral manipulations

Experimental group

Description:

Group B will receive thoracic facet and costovertebral manipulations of the restricted segments between T3 to T9 and ribs 3 to 9 (costovertebral joints), in the prone position. The duration of the intervention will be followed by 4 weeks 3 sessions each week and pre and post-intervention observations will be recorded. * Hypothenar Costal Manipulative technique * Ilial Hypothenar costal manipulation between T3-T9

Treatment:

Other: thoracic facet and costovertebral manipulations