This goes along perfectly with Monday's post, "No Pain, No Patient?"
You don't see too much literature or reports out there on the debilitating thoracic spine conditions keeping people out of work and costing bajillions of dollars. Nevertheless, you should treat it because it is often dysfunctional. Here are 5 More Reasons to Treat the Thoracic Spine
1) It helps the cervical spine
- thrust manipulation to the upper and mid thoracic spines has been demonstated to help the cervical spine according to a few CPRs
- often the neck can be a controversial place to manipulate and some groups are diametrically opposed to it
- no matter, manipulation of the thoracic spine seems to have the same and less dangerous effects!
- an added benefit is treating an area that is DN, for a DP complaint of cervical spine pain
- if the patient is adverse to touch or movement of the cervical spine, treating an area that they are not apprehensive may be a gateway to cervical work
- as many mechanical HA seem to be cervicogenic in origin, manipulation/mobilization to the upper and mid thoracic spines again also help headaches by extension
- lumbar manipulation risk for adverse events estimated at less than 1 in 10,000,000 and cervical spine anywhere between 1 and 100,000 to 1 in 1,000,000
- thoracic spine? Not really studied, as in it's not happening
- there is apparently a risk of fracture but it's a stable area with at least 8 facets per spinal level
- less yacking, more cracking as Homer would say!
- thoracic manipulation should improve thoracic mobility which is a necessary component of shoulder girdle mobility
- it has been demonstrated to improve frozen shoulder mobility, again, treating the DN adjacent area of a DP complaint
- breathing requires proper rib expansion, a component of thoracic mobility
- breathing pattern disorders have been demonstrated in chronic HA, cervical pain, and lumbar pain
- other than teaching proper breathing techniques, thoracic manual therapy may assist, along with diaphragm release and inhibition of sternal elevators using gentle STM or reciprocal inhibition techniques
Upper thoracic thrust for HA
My favorite thoracic manipulation technique
Keeping it Eclectic!