A comparison of two non-thrust mobilization techniques applied to the C7 segment in patients with restricted and painful cervical rotation

Abstract

Objectives: Cervical mobilization and manipulation have been shown to improve cervical range of motion and pain. Rotatory thrust manipulation applied to the lower cervical segments is associated with controversy and the potential for eliciting adverse reactions (AR). The purpose of this clinical trial was to describe two translatory non-thrust mobilization techniques and evaluate their effect on cervical pain, motion restriction, and whether any adverse effects were reported when applied to the C7 segment. Methods: This trial included 30 participants with painful and restricted cervical rotation. Participants were randomly assigned to receive one of the two mobilization techniques. Active cervical rotation and pain intensity measurements were recorded pre-and post-intervention. Within group comparisons were determined using the Wilcoxon signed-rank test and between group comparisons were analyzed using the Mann-Whitney U test. Significance was set at P50.05. Results: Thirty participants were evaluated immediately after one of the two mobilization techniques was applied. There was a statistically significant difference (improvement) for active cervical rotation after application of the C7 facet distraction technique for both right (P50.022) and left (P50.022) rotation. Statistically significant improvement was also found for the C7 facet gliding technique for both right (P50.022) and left rotation (P50.020). Pain reduction was statistically significant for both right and left rotation after application of both techniques. Both mobilization techniques produced similar positive effects and one was not statistically superior to the other. Discussion: A single application of both C7 mobilization techniques improved active cervical rotation, reduced perceived pain, and did not produce any AR in 30 patients with neck pain and movement limitation. These two non-thrust techniques may offer clinicians an additional safe and effective manual intervention for patients with limited and painful cervical rotation. A more robust experimental design is recommended to further examine these and similar cervical translatory mobilization techniques.

Immediate effects of cervicothoracic junction mobilization versus thoracic manipulation on the range of motion and pain in mechanical neck pain with cervicothoracic junction dysfunction: a pilot randomized controlled trial

“…CT junction mobilizations delivered in this study could have reduced the stiffness at this segment and increased the overall cervical ROM. The increase in cervical ROM (in degrees) is almost equivalent to the previous studies after a single session of CT junction mobilization [ 8 , 11 ]. The thoracic manipulation group received treatment to an adjacent interdependent spinal region and demonstrated improvements in the study.…”

“…Improving the mobility of the CT junction reduces the demand for movement in the mid and lower cervical segments, thereby reducing the stress on the cervical spine. In addition, CT junction has been considered a safe segment to perform mobilizations in neck pain [ 8 ].…”

“…Despite the proposed role of CT junction hypomobility in causing neck pain, very few studies have investigated the effectiveness of CT junction mobilization in neck pain. A quasi-experimental trial by Creighton et al, [ 8 ] compared 2 mobilizations (gliding and distraction) techniques applied to the C7-T1 segment and reported an increased rotation range of motion (ROM) and reduced pain intensity after a single treatment session of both techniques. Another pre-post single group trial delivered 3 sessions of Mulligan’s Sustained Natural Apophyseal Glides (SNAGs) explicitly to the cervicothoracic region (C5-T4 levels), where only one participant received SNAGs to the C7 level [ 10 ].…”

Effect of Manual Therapy and Splint Therapy in People with Temporomandibular Disorders: A Preliminary Study

“…MT treatment: The protocol consisted of a combination of ten techniques applied on the cervical, suboccipital, and temporomandibular areas: (1) neck accessory mobilization technique on C7 vertebra [16]; (2) mobilization neck central with posterior-anterior C5 vertebra mobilization [15];…”

“…In this regard, a relationship between TMD and cervical dysfunction (one of the major goals of MT techniques) has been highlighted by several authors, explained by the topographic arrangement between the cervical spine and the trigeminal nerve [14]. Thus, upper neck mobilization has been shown to reduce pain and improve mobility of the craniocervical region in subjects with TMD [15,16]. In line with this, it has been reported that soft tissue manipulative treatment in suboccipital trigger points [17] and in the TMJ region improve muscle function, joint movement, and pain [18].…”