Manual therapies in non-specific neck with upper limb pain

Completed

Brief Summary: This study will be a randomized clinical trial aimed to find and compare the short-term effects of mobilization and manipulation of thoracic spine in chronic non-specific neck arm pain individuals.Interventions will be done on a single day and outcome measures such as intensity of pain on VAS, pressure pain sensitivity and neural tissue sensitivity will be evaluated before intervention, immediately after intervention and 48hr post-intervention.

Recruitment & Eligibility

Inclusion Criteria

Age- 18-65 years 2.
Unilateral neck and arm pain below elbow 3.
No evidence of nerve root compression i.e absence signs of radiculopathy(subjects should have normal sensory and motor function, negative foraminal compression test) 4.
Absence of a specific diagnosis 5.
Symptom duration more than 3 months 6.
Pain intensity â‰¥ 3 on a VAS 7.
Neck disability index â‰¥ 10 on 50 point scale 8.
Evidence of increased peripheral nerve sensitivity to mechanical stimuli ( pain with nerve palpation reveal highly sensitized nerve to mechanical stimuli) 9.
Pain in response to a nerve provocation test in the upper limb (will be performed in supine lying that involves the following: gentle scapular depression, shoulder abduction, forearm supination combined with wrist and finger extension, shoulder external rotation, and elbow extension.
The test was considered positive with the reproduction of arm symptoms.

Exclusion Criteria

Any definite pathology resulting neck and arm pain 2.
Concussion, loss of consciousness, or head injury as a result of the accident 3.
Presence of any signs of nerve root dysfunction, ie, features of radiculopathy 4.
Evidence of metabolic, Other neurological, psychiatric and cardiovascular disorder 5.
Previous neck and shoulder girdle surgery 6.
History of lumbar surgery and/or sciatica or other musculoskeletal disorders that potentially might affect the sensation in the lower limb to be tested 7.
Inflammatory conditions; fibromyalgia; chronic fatigue syndrome 8.
Other contraindications for manual therapy 9.
Withdrawal of consent.

Primary Outcome Measures

Name	Time	Method
1. Intensity of pain on visual analogue scale (VAS)	1. Before intervention \| 2. Immediately after intervention \| 3. 48hr post-intervention
2. Pressure pain sensitivity:Pressure pain thresholds (PPT) will be measured using a pressure algometer (Greenwich, USA). PPT will be measured over trapezius,1st webspace for primary hyperalgesia and over tibialis anterior muscle belly(homolateral) for widespread hyperalgesia.	1. Before intervention \| 2. Immediately after intervention \| 3. 48hr post-intervention
3. Neural tissue sensitization:It will be measured using the upper limb neurodynamic test 1(median nerve) and PPT over median nerve will be taken.	1. Before intervention \| 2. Immediately after intervention \| 3. 48hr post-intervention

Secondary Outcome Measures

Name	Time	Method
a. Global rate of change(GOC)	1. Before intervention

Locations (1): All India Institute of Medical Sciences, New Delhi
🇮🇳
South, DELHI, India
All India Institute of Medical Sciences, New Delhi
🇮🇳South, DELHI, India
Pradeep kumar sahu
Principal investigator
8384065426
pksahu9938@gmail.com