University of Oulu

Määttä, J., Takatalo, J., Leinonen, T., Pienimäki, T., Ylinen, J., & Häkkinen, A. (2022). Lower thoracic spine extension mobility is associated with higher intensity of thoracic spine pain. Journal of Manual & Manipulative Therapy, 30(5), 300–308.

Lower thoracic spine extension mobility is associated with higher intensity of thoracic spine pain

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Author: Määttä, Juhani1,2; Takatalo, Jani1,2,3; Leinonen, Tero2,4;
Organizations: 1Medical Research Center Oulu, University of Oulu, Oulu, Finland
2Loisto Terveys, Oulu, Finland
3Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
4Fysios Oulu, Oulu, Finland
5Department of Physical and Rehabilitation Medicine, University of Oulu, Oulu, Finland
6Central Hospital of Central Finland, Jyväskylä, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
Persistent link:
Language: English
Published: Informa, 2022
Publish Date: 2022-11-04


Objectives: To evaluate the association of thoracic spine (TS) posture and mobility with TS pain.

Methods: Participants with TS pain reported maximum, average, and night pain in TS area, and pain summary score was calculated. Upright and sitting TS postures were evaluated by inspection. TS posture and mobility (flexion and extension) were recorded using an inclinometer and a tape measure, respectively. Correlations between posture and mobility assessments were calculated using Spearman rank correlation, the association of TS posture and mobility with TS pain by logistic regression analysis.

Results: The participants’ (n = 73, 52 females, age range 22–56) TS pain duration was 12 weeks on average. The correlations for measurements of TS posture and flexion mobility were higher than correlations of other TS measurements being between 0.53 and 0.82. Decreased extension mobility of the upper (from 1st to 6th TS segments; Th1–Th6) TS was associated with higher worst pain (OR 1.04, 95% CI 1.00–1.07) and whole TS with pain sum score (OR 1.05, 95% CI 1.01–1.08). Less kyphotic whole TS was associated with lower pain sum score (OR 0.96, 95% CI 0.92–1.00). Greater flexion mobility of upper and lower (Th6–Th12) TS were associated with lower pain sum score (OR 0.96, 95% CI 0.91–1.00, and OR 0.96, 95% CI 0.91–1.00, respectively).

Conclusions: Reduced thoracic extension mobility was associated with higher pain scores and the greater flexion mobility with lower pain scores. Future research is warranted to evaluate if treatments geared toward TS extension mobility improvements would result in lower TS pain.

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Series: Journal of manual & manipulative therapy
ISSN: 1066-9817
ISSN-E: 2042-6186
ISSN-L: 1066-9817
Volume: 30
Issue: 5
Pages: 300 - 308
DOI: 10.1080/10669817.2022.2047270
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This work was supported by the Juho Vainio Foundation.
Copyright information: © 2022 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.