Effects of Thoracic Spine and Cervical Spine Mobilization on Pain, Functional Disability, and Quality of Life in Patients With Mechanical Neck Pain.

Summary

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.

Conditions

• Mechanical Neck Pain

Interventions

OTHER

Cervical Spine Maitland Mobilization

Participants in this group will receive cervical spine Maitland mobilization in addition to standard physiotherapy care. The program will be delivered for 8 weeks, with 2 sessions per week, each session lasting approximately 30 minutes. Mobilization will be performed according to the Maitland concept, with Grades I and II techniques applied for pain modulation and Grades III and IV for improving joint mobility, depending on patient tolerance. Each targeted cervical segment (C2-C7) will receive 3 sets of oscillations lasting 30-60 seconds, with short rest intervals between sets. The intervention aims to restore segmental mobility, reduce pain, and improve functional outcomes.

OTHER

Thoracic plus Cervical Spine Maitland Mobilization

Participants in this group will receive combined thoracic and cervical spine Maitland mobilization in addition to standard physiotherapy care. The program will be conducted for 8 weeks, with 2 sessions per week, each session lasting approximately 30 minutes. Thoracic mobilization will be applied to upper thoracic segments (T1-T4) using central posterior-to-anterior oscillatory techniques, primarily Grades III and IV to improve extension mobility. This will be followed by cervical spine mobilization using the same protocol as Group A. Thoracic mobilization will be performed for approximately 6-8 minutes, followed by cervical mobilization for 8-10 minutes. The combined approach aims to reduce cervical mechanical stress through regional interdependence, improve mobility, and enhance pain relief and functional outcomes.

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences

  lead OTHER

Principal Investigators

• Shoaib Waqas · Lahore University of Biological and Applied Sciences

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

20 Years

Max Age

40 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-05-01

Primary Completion

2026-07-30

Completion

2026-09-15

Countries

• Pakistan

Study Locations