None listed
Conditions
Brief summary
At present only one randomized controlled trial has been performed assessing the effectiveness of spinal manipulative therapy on thoracic spinal pain (Schiller 1999). Several limitations were observed resulting in the Schiller concluding that further studies are required. Graston therapy is a massage system revolving around several hand-held stainless steel instruments (Graston Technique 2006). The founders claim that the instruments have the ability to detect fascial adhesions and restrictions, aiding in achieving improved outcomes for conditions such as thoracic pain (Graston Technique 2006). No high quality trials have been performed to test the efficacy and effectiveness of this method. Given the popularity of spinal manipulation and massage for back pain and the lack of data there is a need for further high quality studies The objective of this investigation is to determine the effectiveness of SMT and GT compared to a pseudo-sham in the treatment of non specific thoracic spine pain. Specifically, the null hypotheses are: 1. Perception of pain as measured by a 100mm visual analogue scale (VAS) will not differ between groups after 3 weeks of either SMT, GT or detuned short wave diathermy and detuned ultrasound 2. Function as measured by the Oswestry Back Pain Disability Index will not differ between groups under these study conditions
Interventions
Spinal manipulative Therapy- taking the joint slack to the elastic barrier and applying a high velocity, low amplitude thrust at the level and in the direction of notional loss of joint motion; consultation is approximately 15 minutes in duration; 10 sessions over 3-4 weeks
Graston Therapy - a patented form of intrumentation used for soft tissue massage/ mobilisation; 15 minutes in duration; 10 sessions over 3-4 weeks
Sponsors
Bruce Walker
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Primary complaint of thoracic spine pain from T1-12 - Duration of pain for three months or less - A VAS score of 3 out of 10or greater and an Oswestry Back Pain Disability index score of greater than 30% at baseline - Only patients who received a diagnosis of non specific thoracic pain from the screening clinician will be accepted into the study. Diagnosis will be made by questioning and examining the participant. The descriptive classification by Triano et al (1980) will be used to diagnose non specific thoracic spine pain (Midline back pain, Non dermatomal referred pain difficult to localise, No signs of nerve root tension, No major neurological deficit, Pain with compression over the thoracic spine into spine extension. Reduced range of motion) - Radiographs will be taken when deemed necessary to exclude patients with contraindications to manipulation or other complicating disease, as described in the exclusion criteria. This decision will be based on the criteria set by the National Health and Medical Research Council for Acute Thoracic (AAMPGG, 2003) - Patients will be accepted into the study if they are able to comply with the treatment protocol
Exclusion criteria
- Are aged less than 18 years - Pregnant Females - Have contraindication to manual therapy (inclusive of severe osteoporosis, thoracic fractures, spinal infection, neoplastic disorders, spondyloarthropathy, disc protrusion or generalised infection, i.e. anyone with a temperature greater than 37.5 degrees Celsius) - Have contraindications to Graston therapy (Cancer, Kidney infection, Anti-coagulant Medication, Rheumatoid arthritis, Uncontrolled hypertension, Unhealed fracture, Inflammatory conditions due to infection, Osteomyelitis) - Have somatic conditions found on examination to refer pain to the thoracic spine from outside the defined area (inclusive of cervical zygapophyseal joints, muscles and discs) - Have an active history of visceral conditions referring pain to the thoracic spine (inclusive of myocardial ischaemia, dissecting thoracic aortic aneurysm, peptic ulcer, acute cholecystitis, pancreatitis, renal colic, acute pyelonephritis) - Current and known substance abuse - Are not fluent and/ or literate in the English language - Are currently receiving care for thoracic pain from any other provider - Cannot commit to full study protocol - Are currently seeking compensation or have commenced litigation for thoracic spine pain
Outcome results
None listed