The effects of the T6 sustained natural apophyseal glide (SNAG) with rotation in mechanical chronic thoracic spine pain: a randomized controlled trial

Abstract

Mechanical thoracic pain is considered one of most common in office worker, which can be as disabling as cervical and low back pain.  Recently, Mulligan have been widely used to relieve pain and increase range of motion in spine pain however, there is no evidence for the use of rotation SNAG in office worker with mechanical thoracic pain. Thus, the objectives of this study was to investigate an immediate effect of T6 sustained natural apophyseal glide (SNAG) with rotation in mechanical thoracic spine pain on level of pain and thoracic range of motions. Thirty-eight volunteers, age between 18-35 years old, with mechanical thoracic spine pain (visual analogue scale; VAS ≥ 2) participated in this study. Participants were randomized allocated into the T6 SNAG with rotation group (n=19) and the placebo treatment group (n=19). VAS and double inclinometer were used to evaluate at the baseline and immediately post treatment. The global perceived effect (GPE) was used to evaluate at immediately post treatment. Thoracic pain level after treatment in both groups showed significant decrease (p = 0.00 and p = 0.00 respectively) but was not significantly different in thoracic range of motion (p > 0.05)except thoracic flexion in placebo group that significant differences (mean difference= -3.89, p = 0.02).There was a greater improvement (p = 0.00) after T6 SNAGs with rotation than placebo treatment but was not statistically significant in range of motion of thoracic spine in all directions (p > 0.05). All of participants in group were “improved” with treatment (100%). These findings suggest that the use of T6 SNAG with rotation can improve the thoracic pain conditions after treatment immediately.