64 patients were randomized to determine the effect of thoracic thrust manipulation in the treatment of mechanical neck pain. Patients were allocated to one of two groups, the first undergoing cervical spine non-thrust manipulation with additional thoracic spine thrust manipulation, and the second receiving cervical spine non-thrust manipulation only. Two sessions were performed 2 to 3 days apart, with follow-up at 1 week following the first session. Results indicated that the addition of thoracic thrust manipulation to cervical non-thrust manipulation led to significantly larger decreases in pain and disability compared to cervical non-thrust manipulation alone.