Thoracic Posture and Mobility in Mechanical Neck Pain Population: A Review of the Literature

Abstract

Neck pain is a common condition with several proposed biomechanical contributing factors. Thoracic spine dysfunction is hypothesized as one of the predisposing factors, which necessitates the need to explore the contribution of thoracic posture and mobility toward neck pain. Accordingly, the present work aimed to review the existing literature investigating the presence of thoracic spine dysfunction in individuals with neck pain. A literature search was conducted in the three electronic databases of PubMed, CINAHL, and Web of Science. Studies published between 1990 and 2017 were considered. After reviewing the abstracts, two authors independently scrutinized the full-text documents for their relevance. The initial search yielded 2,167 articles, of which nine studies involving comparisons of neck pain patients and healthy controls were identified for the review. Increased thoracic kyphosis was positively correlated with the presence of forward head posture but not uniformly associated with neck pain intensity and disability. Thoracic mobility was reduced in the neck pain population, and the role of thoracic kyphosis as a risk factor for pain development could not be confirmed. Thus, an association exists between thoracic kyphosis and postural alteration in the cervical spine. The review favors the inclusion of thoracic spine assessment and treatment in mechanical neck pain patients. Further studies are needed to investigate the cause-effect relationship between thoracic posture and cervical dysfunction.

The Impact of Ossification Spread on Cervical Spine Function in Patients With Ossification of The Posterior Longitudinal Ligament

“…23,24 Reduced mobility in the thoracic spine has also been reported to cause neck pain and dysfunction. 25 Therefore, when assessing the impact of OPLL on cervical spine function, we believe it is important to pay attention to bridge formation of OPLL, not only in the cervical spine but also in the whole spine. In summary, cervical spine dysfunction can be divided into two categories namely, functional impairment due to pain radiating to the neck and shoulders and structural impairment due to decreased mobility of the whole spine caused by bridge formations of ossi ed lesions spreading to the vertebral body.…”

Immediate effects on cervical mobility and spiratory flow, after bilateral manipulation of first rib, in non-specific chronic neck pain: study protocol for a randomized controlled trial

“…On the other hand, anatomobiomechanical disposition of cervicothoracic complex could also be affected in cases of chronic neck pain due to movement limitation in different joint planes from this region, [42] where rst rib is a point of union and interconnection between cervical region and high thoracic wall. [42][43][44] That's why the input over rst rib and his neurophysiological effect could improve range of movement, pain perception and respiratory function present in subjects with chronic non-speci c neck pain. [45] We have designed a randomized, controlled, double-blinded clinical trial, with the aim that our study could contribute to increase scienti c knowledge about this issue, and could initiate new lines of future research.…”

Immediate effects on cervical mobility and spiratory flow, after bilateral manipulation of first rib, in non-specific chronic neck pain: study protocol for a randomized controlled trial

“…On the other hand, anatomobiomechanical disposition of cervicothoracic complex could also be affected in cases of chronic neck pain due to movement limitation in different joint planes from this region, [42] where first rib is a point of union and interconnection between cervical region and high thoracic wall. [42][43][44] That's why the input over first rib and his neurophysiological effect could improve range of movement, pain perception and respiratory function present in subjects with chronic non-specific neck pain. [45] We have designed a randomized, controlled, double-blinded clinical trial, with the aim that our study could contribute to increase scientific knowledge about this issue, and could initiate new lines of future research.…”