Dysfunction of the thoracic spine

Question 1

Features

Answer 1

Also called thoracic hypomobility syndrome,

It’s the outstanding cause of pain (often interscapular) presenting to the practitioner

relatively easy to diagnose

usu. responds dramatically to a simple spinal manipulation treatment (beware of spinal disease, esp. osteoporosis).

Association: chronic poor posture

Diagnosis confirmation: examination of spine, X-ray (if red flags)

Question 2

Management

Answer 2

Explanation and reassurance that spontaneous recovery likely

Continued activity if pain permits

Back education program

Spinal manipulation only if appropriate (very effective)

Spinal mobilisation (if manipulation contraindicated)

Simple analgesics as required, e.g. paracetamol 1g (o) qid

Exercise program, esp. extension exercises

Posture education