Mechanical Neck PainNCT07723001
Effects of Thoracic Spine and Cervical Spine Mobilization on Pain, Functional Disability, and Quality of Life in Patients With Mechanical Neck Pain.
A study testing Cervical Spine Maitland Mobilization and Thoracic plus Cervical Spine Maitland Mobilization in people with Mechanical Neck Pain, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
Trial summary
Mechanical neck pain (MNP) is characterized as neck discomfort mostly originating from musculoskeletal components such as cervical facet joints, intervertebral discs, ligaments, and musculature, in the absence of indications of nerve root compression or severe pathological conditions. Read more about this study
- Who is it for?
- Ages 20 to 40 years
- Conditions the study is for
- Mechanical Neck Pain
- What is being tested?
- Cervical Spine Maitland Mobilization and Thoracic plus Cervical Spine Maitland Mobilization
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 66 participants
- Where
- 1 sitePakistan
- Study dates
- 1 May 2026to 15 Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Participants of both genders aged between 20 and 40 years with a clinical diagnosis of mechanical neck pain will be included in the study. Eligible participants must have a history of neck pain lasting more than 4 weeks (subacute to chronic) and demonstrate mild to moderate functional disability, defined by a Neck Disability Index (NDI) score between 10% and 50%.
Who cannot join
- Participants will be excluded if they present with signs or symptoms of cervical radiculopathy or myelopathy, such as a positive Spurling's test accompanied by neurological deficits, dermatomal numbness, or myotome weakness. Individuals with a history of cervical spine fracture, dislocation, or spinal surgery, as well as those with inflammatory, infectious, or neoplastic spinal conditions, will also be excluded. Additional exclusion criteria include diagnosed osteoporosis or prolonged use of systemic corticosteroids, severe cervical spine instability or vertebrobasilar insufficiency, recent trauma to the cervical or thoracic spine within the past 6 months, presence of systemic neurological disorders, pregnancy, and current participation in another physiotherapy or clinical trial for neck pain.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Lahore University of Biological & Applied Sciences (UBAS)
Lahore, Punjab Province, 53400
Dr.Muhammad Tariq Shafi, MSPT, +923454190056, muhammad.tariq@ubas.edu.pk
About this study
Mechanical neck pain (MNP) is characterized as neck discomfort mostly originating from musculoskeletal components such as cervical facet joints, intervertebral discs, ligaments, and musculature, in the absence of indications of nerve root compression or severe pathological conditions. Although recent evidence supports the use of both cervical and thoracic mobilization for mechanical neck pain, there remains limited comparative research examining their combined or relative effects on pain, functional disability, and quality of life. A total of 66 Participants with mechanical neck pain (> 4 weeks) will be randomly allocated into two groups: Group A (Cervical spine Maitland mobilization group) will receive cervical spine Maitland mobilization throughout the 8-week intervention period, with sessions conducted twice weekly from pre-treatment to post-treatment assessment, Each session will be lasted approximately 30 minutes, consisting of manual therapy followed by standardized therapeutic exercises, supervised exercises will be performed for approximately 15 minutes. Additionally, participants in both groups will be prescribed a daily home exercise program lasting 10-15 minutes. Group B (Thoracic Plus Cervical Spine Maitland Mobilization) will receive combined thoracic and cervical spine Maitland mobilization, Thoracic mobilization will be applied to the upper thoracic segments (T1-T4) using central PA Technique. Grades III and IV mobilizations for thoracic stiffness and restore extension mobility, while lower grades will be applied in cases of increased pain sensitivity. Thoracic mobilization will be delivered for approximately 6-8 minutes, after that cervical mobilization with same protocol of supervised exercise and home pan for mechanical neck pain will be used. Each treatment session will be lasted approximately 30 minutes. Outcome measures will include: Pain intensity assessed using the Visual Analogue Scale (VAS) Functional disability will be evaluated using the Neck Disability Index (NDI), Health-related quality of life will be measured using the Short Form-36 (SF-36). The primary objective of this study is to evaluate the effects of cervical spine mobilization and thoracic spine mobilization on pain intensity, functional disability, and quality of life in patients with mechanical neck pain.
Read the detailed description
Mechanical neck pain (MNP) is a common musculoskeletal condition characterized by localized or unilateral neck pain arising from cervical musculoskeletal structures, without nerve root involvement. It is frequently associated with restricted cervical and thoracic mobility, muscle stiffness, reduced range of motion, and functional limitations, which can significantly impair daily activities, work performance, and overall quality of life. Due to its high prevalence and recurrent nature, effective conservative physiotherapy management is essential.
Among commonly used physiotherapy interventions, spinal mobilization techniques particularly cervical spine mobilization and thoracic spine mobilization are widely applied to reduce pain, improve joint mobility, and enhance functional outcomes. Cervical mobilization focuses on restoring segmental mobility of the cervical spine and modulating pain through mechanical and neurophysiological mechanisms. In contrast, thoracic spine mobilization targets the upper thoracic region to improve extension mobility and reduce biomechanical stress on the cervical spine through the concept of regional interdependence. Although both techniques are frequently used in clinical practice, there is limited comparative evidence regarding their individual and combined effectiveness in patients with mechanical neck pain.
This study is designed as a two-arm parallel randomized controlled trial. A total of 66 participants diagnosed with mechanical neck pain will be recruited using a convenience sampling technique. Participants will be randomly allocated into two groups using computer-generated randomization with a 1:1 allocation ratio. Allocation concealment will be ensured using sealed opaque envelopes, and outcome assessment will be performed by a blinded assessor.
Participants in Group A will receive cervical spine Maitland mobilization applied to symptomatic cervical segments (C2-C7) using graded oscillatory techniques for pain reduction and mobility improvement. Participants in Group B will receive combined thoracic and cervical spine Maitland mobilization, where thoracic mobilization will be applied to upper thoracic segments (T1-T4) followed by cervical mobilization within the same session.
Both groups will receive standardized physiotherapy care, including patient education on posture and ergonomics, along with a structured home exercise program focusing on cervical mobility and postural control. The intervention will be conducted over a period of 8 weeks, with 2 sessions per week. Each session will last approximately 30 minutes.
Outcome measures will include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), functional disability measured by the Neck Disability Index (NDI), and quality of life evaluated using the Short Form-36 (SF-36). Assessments will be conducted at baseline, mid-intervention (4 weeks), and post-intervention (8 weeks).
Data will be analyzed using SPSS software. Normality of data will be assessed using the Shapiro-Wilk test, and appropriate parametric or non-parametric tests will be applied for within-group and between-group comparisons.
This study aims to provide evidence regarding the effectiveness of cervical spine mobilization alone versus combined thoracic and cervical spine mobilization in improving pain, functional disability, and quality of life in patients with mechanical neck pain, thereby contributing to evidence-based physiotherapy practice.
- Conditions
- Mechanical Neck Pain
- Being tested
- Cervical Spine Maitland Mobilization, Thoracic plus Cervical Spine Maitland Mobilization
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cervical Spine Maitland MobilizationOther
Participants in this group will receive cervical spine Maitland mobilization in addition to standard physiotherapy care. The program will be delivered for 8 weeks, with 2 sessions per week, each session lasting approximately 30 minutes. Mobilization will be performed according to the Maitland concept, with Grades I and II techniques applied for pain modulation and Grades III and IV for improving joint mobility, depending on patient tolerance. Each targeted cervical segment (C2-C7) will receive 3 sets of oscillations lasting 30-60 seconds, with short rest intervals between sets. The intervention aims to restore segmental mobility, reduce pain, and improve functional outcomes.
Thoracic plus Cervical Spine Maitland MobilizationOther
Participants in this group will receive combined thoracic and cervical spine Maitland mobilization in addition to standard physiotherapy care. The program will be conducted for 8 weeks, with 2 sessions per week, each session lasting approximately 30 minutes. Thoracic mobilization will be applied to upper thoracic segments (T1-T4) using central posterior-to-anterior oscillatory techniques, primarily Grades III and IV to improve extension mobility. This will be followed by cervical spine mobilization using the same protocol as Group A. Thoracic mobilization will be performed for approximately 6-8 minutes, followed by cervical mobilization for 8-10 minutes. The combined approach aims to reduce cervical mechanical stress through regional interdependence, improve mobility, and enhance pain relief and functional outcomes.
| Study group | Role | What they receive |
|---|---|---|
| Cervical Spine Maitland Mobilization | Experimental | Participants in this group will receive cervical spine Maitland mobilization along with standardized physiotherapy care, including patient education on posture, ergonomics, and a structured home exercise program. The intervention will be conducted for 8 weeks, with 2 sessions per week, each lasting approximately 30 minutes. Cervical mobilization will be applied to symptomatic segments (C2-C7) using graded oscillatory techniques to reduce pain and improve cervical mobility Receives: Other: Cervical Spine Maitland Mobilization |
| Thoracic plus Cervical Spine Maitland Mobilization | Active comparator | Participants in this group will receive combined thoracic and cervical spine Maitland mobilization along with standardized physiotherapy care, including posture education and a structured home exercise program. The intervention will be conducted for 8 weeks, with 2 sessions per week, each lasting approximately 30 minutes. Thoracic mobilization will be applied to improve thoracic mobility, followed by cervical mobilization to reduce pain and enhance function. Receives: Other: Thoracic plus Cervical Spine Maitland Mobilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale, Neck Disability Index, Short Form-36 (SF-36)
Outcome assessment will be conducted at baseline (pre-treatment), at 4 weeks (mid-intervention), and at 8 weeks (post-intervention). Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), functional disability using the Neck Disability Index (NDI), and quality of life using the Short Form-36 (SF-36). Data will be analyzed using appropriate statistical tests to compare within-group and between-group differences.
Measured: Baseline, 4 weeks, and 8 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Jul 2026
- Study start1 May 2026
- Primary completion30 Jul 2026 (estimated)
- Study completion15 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Mechanical Neck PainStudies of the same condition, open and under way.
- More trials run by Lahore University of Biological and Applied SciencesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 66 participants (estimated)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Shoaib Waqas, Study chair, Lahore University of Biological and Applied Sciences
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07723001
- Sponsor's protocol ID
- UBAS/ERB/26/04/021
- Status last verified
- Jul 2026
- First submitted
- 20 Jul 2026
- Last updated
- 23 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: baseline participants
Study at a glance
From the registry record, last updated by the sponsor on 23 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Thoracic Spine and Cervical Spine Mobilization on Pain, Functional Disability, and Quality of Life in Patients With Mechanical Neck Pain.
- ClinicalTrials.gov ID
- NCT07723001
- Acronym / sponsor ID
- UBAS/ERB/26/04/021
- Conditions
- Mechanical Neck Pain
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 66 participants (estimated)
- Lead sponsor
- Lahore University of Biological and Applied SciencesUniversity, hospital or other
- Study start
- 1 May 2026 (actual)
- Primary completion
- 30 Jul 2026 (estimated)
- Study completion
- 15 Sep 2026 (estimated)
- First posted
- 23 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Mechanical neck pain (MNP) is characterized as neck discomfort mostly originating from musculoskeletal components such as cervical facet joints, intervertebral discs, ligaments, and musculature, in the absence of indications of nerve root compression or severe pathological conditions. Although recent evidence supports the use of both cervical and thoracic mobilization for mechanical neck pain, there remains limited comparative research examining their combined or relative effects on pain, functional disability, and quality of life. A total of 66 Participants with mechanical neck pain (> 4 weeks) will be randomly allocated into two groups: Group A (Cervical spine Maitland mobilization group) will receive cervical spine Maitland mobilization throughout the 8-week intervention period, with sessions conducted twice weekly from pre-treatment to post-treatment assessment, Each session will be lasted approximately 30 minutes, consisting of manual therapy followed by standardized therapeutic exercises, supervised exercises will be performed for approximately 15 minutes. Additionally, participants in both groups will be prescribed a daily home exercise program lasting 10-15 minutes. Group B (Thoracic Plus Cervical Spine Maitland Mobilization) will receive combined thoracic and cervical spine Maitland mobilization, Thoracic mobilization will be applied to the upper thoracic segments (T1-T4) using central PA Technique. Grades III and IV mobilizations for thoracic stiffness and restore extension mobility, while lower grades will be applied in cases of increased pain sensitivity. Thoracic mobilization will be delivered for approximately 6-8 minutes, after that cervical mobilization with same protocol of supervised exercise and home pan for mechanical neck pain will be used. Each treatment session will be lasted approximately 30 minutes. Outcome measures will include: Pain intensity assessed using the Visual Analogue Scale (VAS) Functional disability will be evaluated using the Neck Disability Index (NDI), Health-related quality of life will be measured using the Short Form-36 (SF-36). The primary objective of this study is to evaluate the effects of cervical spine mobilization and thoracic spine mobilization on pain intensity, functional disability, and quality of life in patients with mechanical neck pain.
Detailed description
Mechanical neck pain (MNP) is a common musculoskeletal condition characterized by localized or unilateral neck pain arising from cervical musculoskeletal structures, without nerve root involvement. It is frequently associated with restricted cervical and thoracic mobility, muscle stiffness, reduced range of motion, and functional limitations, which can significantly impair daily activities, work performance, and overall quality of life. Due to its high prevalence and recurrent nature, effective conservative physiotherapy management is essential.
Among commonly used physiotherapy interventions, spinal mobilization techniques particularly cervical spine mobilization and thoracic spine mobilization are widely applied to reduce pain, improve joint mobility, and enhance functional outcomes. Cervical mobilization focuses on restoring segmental mobility of the cervical spine and modulating pain through mechanical and neurophysiological mechanisms. In contrast, thoracic spine mobilization targets the upper thoracic region to improve extension mobility and reduce biomechanical stress on the cervical spine through the concept of regional interdependence. Although both techniques are frequently used in clinical practice, there is limited comparative evidence regarding their individual and combined effectiveness in patients with mechanical neck pain.
This study is designed as a two-arm parallel randomized controlled trial. A total of 66 participants diagnosed with mechanical neck pain will be recruited using a convenience sampling technique. Participants will be randomly allocated into two groups using computer-generated randomization with a 1:1 allocation ratio. Allocation concealment will be ensured using sealed opaque envelopes, and outcome assessment will be performed by a blinded assessor.
Participants in Group A will receive cervical spine Maitland mobilization applied to symptomatic cervical segments (C2-C7) using graded oscillatory techniques for pain reduction and mobility improvement. Participants in Group B will receive combined thoracic and cervical spine Maitland mobilization, where thoracic mobilization will be applied to upper thoracic segments (T1-T4) followed by cervical mobilization within the same session.
Both groups will receive standardized physiotherapy care, including patient education on posture and ergonomics, along with a structured home exercise program focusing on cervical mobility and postural control. The intervention will be conducted over a period of 8 weeks, with 2 sessions per week. Each session will last approximately 30 minutes.
Outcome measures will include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), functional disability measured by the Neck Disability Index (NDI), and quality of life evaluated using the Short Form-36 (SF-36). Assessments will be conducted at baseline, mid-intervention (4 weeks), and post-intervention (8 weeks).
Data will be analyzed using SPSS software. Normality of data will be assessed using the Shapiro-Wilk test, and appropriate parametric or non-parametric tests will be applied for within-group and between-group comparisons.
This study aims to provide evidence regarding the effectiveness of cervical spine mobilization alone versus combined thoracic and cervical spine mobilization in improving pain, functional disability, and quality of life in patients with mechanical neck pain, thereby contributing to evidence-based physiotherapy practice.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Cervical Spine Maitland Mobilization | Experimental | Other: Cervical Spine Maitland MobilizationParticipants in this group will receive cervical spine Maitland mobilization along with standardized physiotherapy care, including patient education on posture, ergonomics, and a structured home exercise program. The intervention will be conducted for 8 weeks, with 2 sessions per week, each lasting approximately 30 minutes. Cervical mobilization will be applied to symptomatic segments (C2-C7) using graded oscillatory techniques to reduce pain and improve cervical mobility |
| Thoracic plus Cervical Spine Maitland Mobilization | Active comparator | Other: Thoracic plus Cervical Spine Maitland MobilizationParticipants in this group will receive combined thoracic and cervical spine Maitland mobilization along with standardized physiotherapy care, including posture education and a structured home exercise program. The intervention will be conducted for 8 weeks, with 2 sessions per week, each lasting approximately 30 minutes. Thoracic mobilization will be applied to improve thoracic mobility, followed by cervical mobilization to reduce pain and enhance function. |
Who may qualify
- Ages
- 20 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- Participants of both genders aged between 20 and 40 years with a clinical diagnosis of mechanical neck pain will be included in the study. Eligible participants must have a history of neck pain lasting more than 4 weeks (subacute to chronic) and demonstrate mild to moderate functional disability, defined by a Neck Disability Index (NDI) score between 10% and 50%.
Key exclusion criteria (1 listed)
- Participants will be excluded if they present with signs or symptoms of cervical radiculopathy or myelopathy, such as a positive Spurling's test accompanied by neurological deficits, dermatomal numbness, or myotome weakness. Individuals with a history of cervical spine fracture, dislocation, or spinal surgery, as well as those with inflammatory, infectious, or neoplastic spinal conditions, will also be excluded. Additional exclusion criteria include diagnosed osteoporosis or prolonged use of systemic corticosteroids, severe cervical spine instability or vertebrobasilar insufficiency, recent trauma to the cervical or thoracic spine within the past 6 months, presence of systemic neurological disorders, pregnancy, and current participation in another physiotherapy or clinical trial for neck pain.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Cervical Spine Maitland MobilizationParticipants in this group will receive cervical spine Maitland mobilization in addition to standard physiotherapy care. The program will be delivered for 8 weeks, with 2 sessions per week, each session lasting approximately 30 minutes. Mobilization will be performed according to the Maitland concept, with Grades I and II techniques applied for pain modulation and Grades III and IV for improving joint mobility, depending on patient tolerance. Each targeted cervical segment (C2-C7) will receive 3 sets of oscillations lasting 30-60 seconds, with short rest intervals between sets. The intervention aims to restore segmental mobility, reduce pain, and improve functional outcomes. | Other | Cervical Spine Maitland Mobilization |
| Thoracic plus Cervical Spine Maitland MobilizationParticipants in this group will receive combined thoracic and cervical spine Maitland mobilization in addition to standard physiotherapy care. The program will be conducted for 8 weeks, with 2 sessions per week, each session lasting approximately 30 minutes. Thoracic mobilization will be applied to upper thoracic segments (T1-T4) using central posterior-to-anterior oscillatory techniques, primarily Grades III and IV to improve extension mobility. This will be followed by cervical spine mobilization using the same protocol as Group A. Thoracic mobilization will be performed for approximately 6-8 minutes, followed by cervical mobilization for 8-10 minutes. The combined approach aims to reduce cervical mechanical stress through regional interdependence, improve mobility, and enhance pain relief and functional outcomes. | Other | Thoracic plus Cervical Spine Maitland Mobilization |
Primary outcome
Numeric Pain Rating Scale, Neck Disability Index, Short Form-36 (SF-36)
Time frame: Baseline, 4 weeks, and 8 weeks
Outcome assessment will be conducted at baseline (pre-treatment), at 4 weeks (mid-intervention), and at 8 weeks (post-intervention). Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), functional disability using the Neck Disability Index (NDI), and quality of life using the Short Form-36 (SF-36). Data will be analyzed using appropriate statistical tests to compare within-group and between-group differences.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Jul 2026.
- Individual participant dataSharing planned: Yes. baseline participants
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Shoaib Waqas study chair
Lahore University of Biological and Applied Sciences
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Cervical Spine Maitland Mobilization and Thoracic plus Cervical Spine Maitland Mobilization in people with Mechanical Neck Pain, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 23 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Dr.Tariq Shafi, MSPT (+923454190056, muhammad.tariq@ubas.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale, Neck Disability Index, Short Form-36 (SF-36) (time frame: Baseline, 4 weeks, and 8 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Jul 2026.