INTRODUCTION: The aims of this clinical trial were to determine the frequency of thoracic joint dysfunction in whiplash patients, and to evaluate and compare the effects of dorsal manipulation in the treatment of these patients. No controlled experimental trials have been published documenting the effects of this manipulation. DESIGN: A randomized controlled trial. MATERIALS AND METHODS: For the first part of the study, 120 patients with mechanical neck pain and 120 patients diagnosed with whiplash injury were recruited from our clinic. The following null hypothesis was tested: no significant differences in the presence of thoracic joint dysfunction exist among patients diagnosed with mechanical neck pain and patients diagnosed with whiplash injury. For thoracic joint dysfunction diagnosis, manual orthopaedic and osteopathic tests were performed. For the second part, only 88 volunteers patients of the initially 120 participated in this part. Patients were divided randomly into 2 groups, using a table of random numbers: group A (experimental group) and group B (control group). Group A was treated with dorsal manipulation technique plus physiotherapy treatment, and group B was treated only with physiotherapy treatment. The physiotherapy treatment was the same in both groups. It consists in active exercises, electrotherapy, ultrasound therapy and manual therapy. Dorsal manipulation was performed one time at the 5th and 10th sessions. All subjects signed the required consent sheet before becoming part of the study. The outcome measure was the visual analogue scale (VAS) in cervical (neck pain), dorsal region and head pain. Data were collected before beginning the treatment (pre treatment), after 10 sessions (one week after first dorsal manipulation) and after 15 sessions (one week after second dorsal manipulation). RESULTS: In the first part of the study, 69% patients diagnosed with whiplash have thoracic joint dysfunction versus 13% patients diagnosed of mechanical neck pain (p = 0.002). In the second part, the experimental group had a greater reduction of the VAS compared with control group. This comparison was significantly in neck pain after the 2nd manipulative session (p = 0.001) and in dorsal pain after 1st and 2nd manipulative session (p = 0.001 in both sessions). CONCLUSIONS: Thoracic joint dysfunctions are more frequently seen in patients diagnosed with whiplash injury. Dorsal manipulation favours the clinical improvement in whiplash patients.

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