Effects of Thoracic Spine Manipulation With and Without Costovertebral Joint Manipulation in Patients Mid-back Pain
NCT ID: NCT07063992
Last Updated: 2025-07-14
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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NOT_YET_RECRUITING
NA
34 participants
INTERVENTIONAL
2025-07-31
2025-10-31
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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thoracic facet manipulations
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
thoracic facet manipulations
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 manipulationThese flexibility exercises will be targeted for
* Rhomboid and middle trapezius stretching (2-3 times daily; 3 sets for 30 seconds))
* Pectoralis muscle stretch in a corner (2-3 times daily; 3 sets for 30 seconds)
* Prone on the elbow with upper thoracic extension exercise (2-3 times daily; 3 sets for 30 seconds) .
The postural exercises will be the following
* Postural strengthening/ stabilization with back to a wall. The participant will press their arms into the wall while retracting scapulae.
* Trunk rotation stretching in the sitting position
thoracic facet and costovertebral manipulations
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
thoracic facet and costovertebral manipulations
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
Interventions
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thoracic facet manipulations
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 manipulationThese flexibility exercises will be targeted for
* Rhomboid and middle trapezius stretching (2-3 times daily; 3 sets for 30 seconds))
* Pectoralis muscle stretch in a corner (2-3 times daily; 3 sets for 30 seconds)
* Prone on the elbow with upper thoracic extension exercise (2-3 times daily; 3 sets for 30 seconds) .
The postural exercises will be the following
* Postural strengthening/ stabilization with back to a wall. The participant will press their arms into the wall while retracting scapulae.
* Trunk rotation stretching in the sitting position
thoracic facet and costovertebral manipulations
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
Eligibility Criteria
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Inclusion Criteria
* 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 with contraindications to manipulation in the thoracic spine (15)
* Weakened bone due to: Osteoporosis, Infection and Neoplasm
18 Years
45 Years
ALL
No
Sponsors
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Riphah International University
OTHER
Responsible Party
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Principal Investigators
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Samrood Akram, PhD*
Role: PRINCIPAL_INVESTIGATOR
Riphah International University
Locations
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Sehat Medical Complex
Lahore, Punjab Province, Pakistan
Countries
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Central Contacts
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Facility Contacts
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References
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Cibulka M, Buck J, Busta B, Neil E, Smith D, Triller R. Intra and inter observer agreement in the mobility assessment of the upper thoracic costovertebral joints. Physiother Theory Pract. 2023 Sep 2;39(9):1993-1999. doi: 10.1080/09593985.2022.2058439. Epub 2022 Mar 27.
Koivunen K, Widbom-Kolhanen S, Pernaa K, Arokoski J, Saltychev M. Reliability and validity of Oswestry Disability Index among patients undergoing lumbar spinal surgery. BMC Surg. 2024 Jan 3;24(1):13. doi: 10.1186/s12893-023-02307-w.
Kirsten Elizabeth Petrie. E. K. (2019). Costovertebral Manipulation versus Ultrasound Therapy of Rhomboid Trigger Points and a Combination Thereof in Treating Inter-scapular Pain. PQDT-Global.
Honore M, Picchiottino M, Wedderkopp N, Leboeuf-Yde C, Gagey O. What is the effect of spinal manipulation on the pressure pain threshold in young, asymptomatic subjects? A randomized placebo-controlled trial, with a cross-over design. Chiropr Man Therap. 2020 Feb 7;28(1):6. doi: 10.1186/s12998-020-0296-1.
Masaracchio M, Kirker K, States R, Hanney WJ, Liu X, Kolber M. Thoracic spine manipulation for the management of mechanical neck pain: A systematic review and meta-analysis. PLoS One. 2019 Feb 13;14(2):e0211877. doi: 10.1371/journal.pone.0211877. eCollection 2019.
Honore M, Leboeuf-Yde C, Gagey O. The regional effect of spinal manipulation on the pressure pain threshold in asymptomatic subjects: a systematic literature review. Chiropr Man Therap. 2018 Apr 19;26:11. doi: 10.1186/s12998-018-0181-3. eCollection 2018.
Tsegay GS, Gebregergs GB, Weleslassie GG, Hailemariam TT. Effectiveness of Thoracic Spine Manipulation on the Management of Neck Pain: A Systematic Review and Meta-Analysis of Randomized Control Trials. J Pain Res. 2023 Feb 27;16:597-609. doi: 10.2147/JPR.S368910. eCollection 2023.
Other Identifiers
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REC/RCR &AHS/24/0142 Alishah
Identifier Type: -
Identifier Source: org_study_id
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