Manual Therapy

Cervical vs. Thoracic Thrust Joint Manipulations to Decrease Neck Pain

An article in this months journal of orthopaedic and sports physical therapy, examined the ability of a thrust joint manipulation (TJM) directed at the cervical spine to decrease neck pain and improve perceived disability.  The examiners used the current clinical prediction rule for performing a thoracic thrust manipulation and when 4 out of the 6 variables of this CPR were present, patients had a more favorable response when the TJM was directed at the cervical spine vs. thoracic.  Despite a small sample size and only 1 tester, this article demonstrated interesting findings.  To read the original article go here.


  1. symptom duration < 30 days
  2. no symptoms distal to the shoulder
  3. no aggrevation in symptoms by looking up
  4. FABQ score of < 12
  5. Decreased upper thoracic spine kyphosis
  6. Cervical extension ROM < 30deg

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