In 2000, Schiller, et. al., conducted study at the Technikon Natal Chiropractic Clinic in Durban, South Africa, aimed to explore the efficacy of spinal manipulative therapy (SMT) in treating mechanical thoracic spine pain, an area where substantiated studies are currently lacking.

The primary objective was to investigate and compare the effectiveness of spinal manipulative therapy against a placebo treatment in addressing mechanical thoracic spine pain.

The study employed a single-blind, randomized, comparative, controlled pilot design, enrolling thirty participants aged 16 to 60 from the general population. Participants were randomly assigned to either the treatment group, receiving thoracic spinal manipulation, or the placebo group, which underwent nonfunctional ultrasound application. Both groups underwent six treatments over a 2 to 3-week period, with a 1-month follow-up assessment.

Objective measurements included thoracic spine ranges of motion using the BROM II goniometer and pain threshold assessment with an algometer. Subjective information was collected through the Oswestry Back Pain Disability Index, short-form McGill Pain Questionnaire, and Numerical Pain Rating Scale-101 Questionnaire. Data were collected before the first and final treatments, as well as during the 1-month follow-up. Statistical analysis utilized the nonparametric Mann-Whitney U test and Wilcoxon signed-rank test with a confidence level of 95%. Power analysis was also employed to assess the robustness of the results.

Following the final treatment, statistically significant results (P < or = .025) were observed in the treatment group for the percentage of pain experienced (Numerical Pain Rating Scale) and lateral flexion. These benefits were maintained at the 1-month follow-up, although statistical significance was not sustained. Intragroup analysis revealed significant improvements in both subjective and objective measurements for the spinal manipulative therapy group from the first to the final treatment and the first treatment to the 1-month follow-up. The placebo group exhibited a statistically significant improvement in sensory pain only.

While this pilot study suggests that spinal manipulative therapy may provide greater benefits than placebo treatment for mechanical thoracic spine pain, the small sample size underscores the preliminary nature of the findings. These results should be regarded as a foundation for future studies, emphasizing the need for larger sample sizes to enhance result validity and identify subtle changes in measurement parameters.

Reference: Schiller, L. (2001). Effectiveness of spinal manipulative therapy in the treatment of mechanical thoracic spine pain: a pilot randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, 24(6), 394-401.