Mechanical Neck Pain (MNP) is a prevalent musculoskeletal problem. MNP has a high-risk of becoming chronic in nature. Recent studies demonstrate altered Postural Sway (PS) among MNP patients. There are various management strategies used for improving pain and PS among Chronic MNP (CMNP). Numerous studies have been done on the effect of thoracic thrust manipulation on pain. However, the evidence is deficient for the impact of thoracic manipulation on PS in MNP patients. Aim: To analyse the

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... of Thoracic Spine Manipulation (TSM) on pain and PS in CMNP patients. Materials and Methods: The quasi-experimental study was carried out on 31 patients. All the patients received three sessions of thoracic manipulation on three consecutive days. Numeric Rating Scale (NRS) and PS were measured during three treatment sessions and at baseline. One-way repeated measure Analysis of Variance (ANOVA) was used to examine the effects of treatment on each outcome variable. Results: Thirty-one patients with a mean age of 22.23 (SD=2.667) years with 61.3% females, and 38.7% males fulfilled the prerequisite considerations to be in the study. Patients showed significant improvements in pain after TSM 1 (F=105.8, p<0.05). The PS measured as sway velocity based on the Center of Foot Pressure (COFP) showed a significant reduction in both anteroposterior direction (F=3.55, p=0.02) and mediolateral direction PSY (F=5.10, p=0.03). Conclusion: The results demonstrated that thoracic manipulation improves pain and reduces PS. The study concludes that TSM can alter PS immediately post manipulation. TSM can be an alternative to Cervical Spine Manipulation (CSM) in patients with a contraindication for CSM.