Treatment of the thoracic spine utilizing joint mobilization or manipulation is a excellent treatment approach to accelerate the recovery of patients dealing with neck, elbow, and shoulder pain.  Utilizing a regional interdependence approach where areas adjacent or distant to the site of pain are treated by the physical therapist, in addition to the painful area, lead to greater outcomes in fewer visits.  The benefits of manual therapy alone often last 1-2 days but when combined with physical therapy exercises can deliver both short and long term improvements in pain and function.  In our practice, manual therapy treatments produce a valuable reduction in a patient’s pain allowing them to move with less discomfort as we transition into a strengthening program.  Previous research showed patient’s receiving this combined approach demonstrates better outcomes and strength development than those receiving only exercise treatments (Bang et al. 2000). 

Recently, a review of the available literature on manual therapy in the management of shoulder pain was published in the Journal of Manual and Manipulative Therapy (Peek et al. 2015).  The pooled results of the 7 studies found between 76-100% of patients reported significant reductions in shoulder pain immediately after the thoracic manipulation.  Some of the studies demonstrated improved shoulder outcomes up to 1 year after the treatment period.  This review article adds to our available evidence supporting the utilization of thoracic manipulation during physical therapy treatments for shoulder pain.  To learn more about how thoracic manipulation can help you reduce pain and get back to your activities contact your local physical therapist.