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 and 2 others
PMID 30858662WHAT IT FOUND
Adding Rungthip massage to thoracic manipulation, while both groups also received neck care education, lowered resting neck pain more than thoracic manipulation alone over three weeks, but elbow extension during the nerve tension test did not differ.
Key findings
01Both groups had lower resting neck pain after treatment. With thoracic manipulation alone, pain at rest was 45.29 mm before and 20.71 mm after; with thoracic manipulation plus Rungthip massage, pain at rest was 42.33 mm before and 9.67 mm after.
02After adjusting for baseline, the group receiving thoracic manipulation plus Rungthip massage had less resting pain than the group receiving thoracic manipulation only, with a mean difference of 10.89 mm on the 100 mm pain scale (95% CI 3.11 to 18.69; p=0.004); both groups also received neck care education.
03The two groups did not differ significantly in elbow extension ROM at the threshold or tolerance points after treatment (threshold p=0.183; tolerance p=0.749).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 30 participants and recruited them through flyers, mostly young adults, so it may not apply to older or clinic-referred patients. Only short-term outcomes were measured, on the day after the last session, so long-term benefit is unknown. Outcome assessors were blinded, but participants and the treating therapist were not. The paper reports 15 participants assigned to each group, but Table 1 lists 14 in the thoracic manipulation group, so the analysed group size is unclear. The findings are limited to chronic mechanical neck pain and may not apply to acute or sub-acute neck pain. The same therapist delivered both interventions, so results may not generalize to other therapists.
Declared interests
Funded by the Research Center of Back, Neck, Other Joint Pain, and Human Performance. The authors reported no financial disclosures or conflicts of interest.
The easy way to misread this
Do not conclude that Rungthip massage alone reduces neck pain. In this trial it was added to thoracic manipulation, and all participants also received neck care education. The study does not separate the effect of the massage from those other treatments.