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

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 Effects of Increasing Thoracic Mobility on Lumbar Stability

OBJECTIVE: To determine the effects on the lumbar stability caused by various thoracic exercise programs, the extent of spinal posture correction and the increase in thoracic mobility to the extension direction. METHOD: Exercise programs, which can increase the thoracic mobility to the extension direction, were applied to the exercise group. The control subjects were trained for the correct posture according to ergonomic principles by exercise at home and at the clinic. Both groups had three sessions of exercise program per week for 8 weeks. RESULTS: A comparison of the various parameters in the exercise group before and after exercise showed that the VAS, thoracic kyphosis and lumbar mobility decreased significantly (p <0.05), and the thoracic mobility in the extension direction, chest expansion, maximal elevation of the arms and spinal length increased significantly (p <0.05). In addition, the thoracic kyphosis and lumbar mobility increased significantly (p <0.05), and thoracic mobility in the extension direction, chest expansion, maximum elevation of the arms and the spinal length decreased significantly (p <0.05), but the VAS did not show a significant difference. CONCLUSION: A thoracic exercise program, which can correct the posture, improve the functional restrictions of the thoracic spine and reduce the lumbar mobility, is very important.