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Chiropractic Research Review

Thoracic Pain: Is Spinal Manipulation Better than Placebo?

The first chiropractic adjustment on record was performed on the thoracic spine, yet most research on the effects of spinal manipulation has focused on the lumbar or cervical spine. Data on the efficacy of spinal adjustments on thoracic spinal syndromes, such as mechanical spine pain, would provide insight on the benefits of chiropractic care.

Thirty South African patients with thoracic pain were randomly assigned to a control or treatment group.

The treatment group received spinal manipulation, while the control group underwent a series of nonfunctional ultrasound applications; both groups received a maximum of six treatments over two to three weeks. Multiple measurements were taken before the first and final treatments, and one month after the final treatment. The measurements are listed below:

* thoracic range of motion;

* pain threshold (using an algometer);

* Oswestry Back Pain Disability Index;

* short-form McGill Pain Questionnaire; and

* Numerical Pain Rating Scale-101 Questionnaire (NPRS).

Results: Compared to the control group, the manipulation group had less pain and increased rotation and lateral flexion after the final treatment. At one-month follow-up, only lateral flexion was better in the treatment group. The treatment group improved in both subjective and objective tests between the first treatment and one-month follow-up, while the placebo group improved in subjective pain only.

This study implies that chiropractic adjustments may be more beneficial than placebo treatments for thoracic pain, especially regarding short-term measures. The author notes that this is only a pilot study with a small sample size; to add validity to the data, she suggests that future studies with larger samples be completed.

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

Chiropractic Research Review

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