Thoracic Spine Management

Question 1

Thoracic joint dysfunction

Answer 1

Painful joint disorder at the facet costotransverse, or Costovertebral “locking“

onset may be sudden or insidious

Question 2

thoracic joint dysfunction symptoms

Answer 2

Unilateral pain

Cervical or thoracic movements into the joint restriction

Deep breathing into restriction

usually no neuro signs
Radicular nerve symptoms may be present with advanced spondylosis affecting the nerve

Question 3

deformity position for thoracic joint dysfunctions

Answer 3

May assume postural position away from the pain

Limited range of motion into restrictive barriers

Question 4

closing restriction for thoracic joint dysfunction

Answer 4

Pain and limited range of motion with extension and side, bending into the restriction

Question 5

opening restriction with thoracic joint dysfunction

Answer 5

Pain and limited range of motion with flexion and side, bending away from the restriction

Question 6

rib dysfunctions

Answer 6

Painful joint disorder at the costovertebral, costotransverse, costochondral, or sternocostal

torsional rib dysfunction usually due to thoracic joint dysfunction

Question 7

Costochondral, sternocostal dysfunction

Answer 7

Anterior chest pain at the rib, costal cartilage, sternal articulations

often overlooked
Rule out cardiac
Reproducible pain with breathing can help with establishing the cause

Aggravating factors include thoracic, shoulder motion, deep breath, cough, and sneeze

Question 8

first and second ribs

Answer 8

Scalene attachments can cause subluxation
Poor posture
Accessory breathing
Cervical thoracic dysfunction muscle guarding

Question 9

first and second ribs, assessment and treatment

Answer 9

Assessment- palpation assess scalene length, cervical rotation, lateral flexion test

Treatment - manual therapy, stretch scalene, deep neck, flexor, and postural muscle retraining

Question 10

strength programs

Answer 10

Conditioning exercises to focus on
Scapular thoracic stabilization
Cervical thoracic stabilization
Lumbopelvic stability
Upper extremity conditioning
Endurance for daily demands