Integrating thoracic mobility into cervical rehabilitation improves mobility, function, and posture in non-specific chronic neck pain: A randomized controlled trial

Background Chronic non-specific neck pain (CNNP) is a prevalent musculoskeletal disorder associated with pain, postural alterations, reduced spinal mobility, and functional limitations, and emerging evidence suggests that thoracic spine dysfunction may contribute to the persistence of symptoms. Objective This study investigated the effects of adding thoracic mobility exercises to cervical stabilization exercises on three distinct outcome domains in individuals with CNNP: cervical-specific parameters, including pain, cervical muscle strength, and neck disability; thoraco-spinal parameters, including posture and spinal mobility; and proximal upper extremity functionality. Methods In the study, 54 individuals with CNNP were randomized into thoracic mobility (TMG, n = 27) and cervical stabilization groups (CSG, n = 27). Cervical-specific parameters included pain intensity, cervical flexor and extensor strength, and neck-related disability. Thoraco-spinal parameters included posture and spinal mobility assessed using the Spinal Mouse ® device. Proximal upper extremity functionality was assessed using the Disabilities of the Arm, Shoulder and Hand questionnaire. Outcomes were evaluated before treatment and immediately after completion at week six. Results While within-group improvements were observed for all parameters in both groups, adding thoracic mobility exercises provided no superior benefit for pain or cervical muscle strength compared with cervical stabilization alone. In contrast, significant Group × Time interactions favored the thoracic mobility group for posture (η 2 = 0.228), spinal mobility (η 2 = 0.306), neck disability (η 2 = 0.135), and upper extremity function (η 2 = 0.149). Conclusion These findings support the targeted inclusion of thoracic mobility exercises for enhancing postural, spinal mobility, and functional outcomes in individuals with chronic non-specific neck pain, rather than achieving superior pain relief or cervical muscle strength improvement.