The effect of massage technique plus thoracic manipulation versus thoracic manipulation on pain and neural tension in mechanical neck pain: a randomized controlled trial

Rungthip Puntumetakul, Rawiporn Pithak, Suwalee Namwongsa, Pongsatorn Saiklang, Rose Boucaut, Rungthip Puntumetakul, Rawiporn Pithak, Suwalee Namwongsa, Pongsatorn Saiklang, Rose Boucaut

Abstract

[Purpose] To determine the short-term effects of thoracic manipulation, used alone or in conjunction with the Rungthip massage technique, on pain and neural extensibility in patients with chronic mechanical neck pain. [Participants and Methods] Thirty participants were randomly allocated to the aforementioned two groups. Outcome measures were neck pain at rest assessed using the Visual Analog Scale, and elbow extension range of motion evaluated using Upper Limb Neurodynamic Test 1 prior to treatment and three weeks after it. [Results] A statistically significant reduction in resting neck pain, and an improvement in elbow extension range of motion was reported by both groups shortly after the moment when the pain was first felt (threshold level). However, an improvement in elbow extension range of motion was not observed in either group at the maximum level of pain (tolerance level). A significant reduction in resting neck pain was seen in the thoracic manipulation plus Rungthip massage group, compared to that achieved using thoracic manipulation alone. [Conclusion] The use of thoracic manipulation and Rungthip massage is recommended to reduce resting neck pain and increase pain-free neural tissue extensibility.

Keywords: Mechanical neck pain; Rungthip massage technique; Thoracic manipulation.

Figures

Fig. 1.
Fig. 1.
Flowchart diagram of this study.
Fig. 2.
Fig. 2.
Massage technique (RT technique).

References

    1. Guez M, Hildingsson C, Nilsson M, et al. : The prevalence of neck pain: a population-based study from northern Sweden. Acta Orthop Scand, 2002, 73: 455–459.
    1. Côté P, Cassidy JD, Carroll L: The factors associated with neck pain and its related disability in the Saskatchewan population. Spine, 2000, 25: 1109–1117.
    1. Hogg-Johnson S, van der Velde G, Carroll LJ, et al. Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine, 2008, 33: S39–S51.
    1. Hoy DG, Protani M, De R, et al. : The epidemiology of neck pain. Best Pract Res Clin Rheumatol, 2010, 24: 783–792.
    1. Martínez-Segura R, Fernández-de-las-Peñas C, Ruiz-Sáez M, et al. : Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. J Manipulative Physiol Ther, 2006, 29: 511–517.
    1. Maitland GD, Hengeveld E, Banks K, et al. : Maitland’s vertebral manipulation 6th ed. Oxford: Butterworth-Heinemann, 2001.
    1. Bogduk N, Aprill C: On the nature of neck pain, discography and cervical zygapophysial joint blocks. Pain, 1993, 54: 213–217.
    1. Bogduk N: The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am, 2011, 22: 367–382, vii.
    1. Mäkelä M, Heliövaara M, Sievers K, et al. : Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol, 1991, 134: 1356–1367.
    1. Côté P, Cassidy JD, Carroll L: The epidemiology of neck pain: what we have learned from our population-based studies. J Can Chiropr Assoc, 2003, 47: 284–290.
    1. Dommisse GF: Morphological aspects of the lumbar spine and lumbosacral region. Orthop Clin North Am, 1975, 6: 163–175.
    1. Butler DS: Adverse mechanical tension in the nervous system: a model for assessment and treatment. Aust J Physiother, 1989, 35: 227–238.
    1. Butler DS: Mobilization of the nervous system. Melbourne, Australia: Churchill Livingstone, 1991.
    1. Vernon HT, Aker P, Burns S, et al. : Pressure pain threshold evaluation of the effect of spinal manipulation in the treatment of chronic neck pain: a pilot study. J Manipulative Physiol Ther, 1990, 13: 13–16.
    1. Cassidy JD, Lopes AA, Yong-Hing K: The immediate effect of manipulation versus mobilization on pain and range of motion in the cervical spine: a randomized controlled trial. J Manipulative Physiol Ther, 1992, 15: 570–575.
    1. Gross AR, Kay T, Hondras M, et al. : Manual therapy for mechanical neck disorders: a systematic review. Man Ther, 2002, 7: 131–149.
    1. Hoving JL, Gross AR, Gasner D, et al. : A critical appraisal of review articles on the effectiveness of conservative treatment for neck pain. Spine, 2001, 26: 196–205.
    1. Hurwitz EL, Morgenstern H, Harber P, et al. : A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study. Am J Public Health, 2002, 92: 1634–1641.
    1. Hurwitz EL, Aker PD, Adams AH, et al. : Manipulation and mobilization of the cervical spine. A systematic review of the literature. Spine, 1996, 21: 1746–1759, discussion 1759–1760.
    1. Leaver AM, Maher CG, Herbert RD, et al. : A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain. Arch Phys Med Rehabil, 2010, 91: 1313–1318.
    1. Vicenzino B, Paungmali A, Buratowski S, et al. : Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia. Man Ther, 2001, 6: 205–212.
    1. McLean S, Naish R, Reed L, et al. : A pilot study of the manual force levels required to produce manipulation induced hypoalgesia. Clin Biomech (Bristol, Avon), 2002, 17: 304–308.
    1. Coppieters MW, Stappaerts KH, Wouters LL, et al. : The immediate effects of a cervical lateral glide treatment technique in patients with neurogenic cervicobrachial pain. J Orthop Sports Phys Ther, 2003, 33: 369–378.
    1. Cleland JA, Childs JD, McRae M, et al. : Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. Man Ther, 2005, 10: 127–135.
    1. Norlander S, Aste-Norlander U, Nordgren B, et al. : Mobility in the cervico-thoracic motion segment: an indicative factor of musculo-skeletal neck-shoulder pain. Scand J Rehabil Med, 1996, 28: 183–192.
    1. Norlander S, Gustavsson BA, Lindell J, et al. : Reduced mobility in the cervico-thoracic motion segment--a risk factor for musculoskeletal neck-shoulder pain: a two-year prospective follow-up study. Scand J Rehabil Med, 1997, 29: 167–174.
    1. Fernández-de-las-Peñas C, Pérez-de-Heredia M, Brea-Rivero M, et al. : Immediate effects on pressure pain threshold following a single cervical spine manipulation in healthy subjects. J Orthop Sports Phys Ther, 2007, 37: 325–329.
    1. Pickar JG: Neurophysiological effects of spinal manipulation. Spine J, 2002, 2: 357–371.
    1. Wright A: Hypoalgesia post-manipulative therapy: a review of a potential neurophysiological mechanism. Man Ther, 1995, 1: 11–16.
    1. Puntumetakul R, Suvarnnato T, Werasirirat P, et al. : Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial. Neuropsychiatr Dis Treat, 2015, 11: 137–144.
    1. Suvarnnato T, Puntumetakul R, Kaber D, et al. : The effects of thoracic manipulation versus mobilization for chronic neck pain: a randomized controlled trial pilot study. J Phys Ther Sci, 2013, 25: 865–871.
    1. Cleland JA, Glynn P, Whitman JM, et al. : Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther, 2007, 87: 431–440.
    1. Salom-Moreno J, Ortega-Santiago R, Cleland JA, et al. : Immediate changes in neck pain intensity and widespread pressure pain sensitivity in patients with bilateral chronic mechanical neck pain: a randomized controlled trial of thoracic thrust manipulation vs non-thrust mobilization. J Manipulative Physiol Ther, 2014, 37: 312–319.
    1. Puntumetakul R, Pithak R, Eungpinichpong W, et al. : Immediate effects of special massage technique from inferior angle of scapula to the lowest rib in neck pain patients. J Med Tech Phys Ther, 2016, 28: 135–143.
    1. Bijur PE, Silver W, Gallagher EJ: Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med, 2001, 8: 1153–1157.
    1. Bird SB, Dickson EW: Clinically significant changes in pain along the visual analog scale. Ann Emerg Med, 2001, 38: 639–643.
    1. Gallagher EJ, Liebman M, Bijur PE: Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med, 2001, 38: 633–638.
    1. Vanti C, Conteddu L, Guccione A, et al. : The Upper Limb Neurodynamic Test 1: intra- and intertester reliability and the effect of several repetitions on pain and resistance. J Manipulative Physiol Ther, 2010, 33: 292–299.
    1. Lohkamp M, Small K: Normal response to upper limb neurodynamic test 1 and 2A. Man Ther, 2011, 16: 125–130.
    1. Melzack R, Wall PD: Pain mechanisms: a new theory. Science, 1965, 150: 971–979.
    1. Shacklock M: Clinical neurodynamics: a new system of musculoskeletal treatment. Oxford: Elsevier, 2005.
    1. Coppieters M, Stappaerts K, Janssens K, et al. : Reliability of detecting ‘onset of pain’ and ‘submaximal pain’ during neural provocation testing of the upper quadrant. Physiother Res Int, 2002, 7: 146–156.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere