Effects of Thoracic Spine Manipulation With and Without Costovertebral Joint Manipulation in Patients Mid-back Pain

"Group A will receive thoracic facet manipulations of the restricted segments between T3 to T9, in the prone position and cephalic direction. The duration of the intervention will be followed by 4 weeks 3 sessions each week and pre- and post-intervention observations will be recorded.~Bilateral hypothenar Cross bilateral hypothenar manipulationThese flexibility exercises will be targeted for~* Rhomboid and middle trapezius stretching (2-3 times daily; 3 sets for 30 seconds))~* Pectoralis muscle stretch in a corner (2-3 times daily; 3 sets for 30 seconds)~* Prone on the elbow with upper thoracic extension exercise (2-3 times daily; 3 sets for 30 seconds) .~The postural exercises will be the following~* Postural strengthening/ stabilization with back to a wall. The participant will press their arms into the wall while retracting scapulae.~* Trunk rotation stretching in the sitting position"

"Group B will receive thoracic facet and costovertebral manipulations of the restricted segments between T3 to T9 and ribs 3 to 9 (costovertebral joints), in the prone position. The duration of the intervention will be followed by 4 weeks 3 sessions each week and pre and post-intervention observations will be recorded.~Hypothenar Costal Manipulative technique Ilial Hypothenar costal manipulation between T3-T9"