The effectiveness of spinal manipulative therapy (SMT) versus Graston therapy (GT) in the treatment of non-specific thoracic pain: A randomised controlled trial

INTERVENTION: 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 CONDITION: Non specific Thoracic Pain PRIMARY OUTCOME: Oswestry Back pain Disability Index (ODI) ‐ participants must have an index score of greater than 30% at baseline Visual Analogue Scale (VAS)‐ participants must have a score of 3 or greater out of 10 SECONDARY OUTCOME: 36‐item short form health survey (SF‐36) ‐ sociodemographic information such as age, sex, racial ethnicity, education, employment, maritall status and income 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 b