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Thoracic pain and mobility deficits
We often see patients with both thoracic pain with range of motion/mobility impairments. The first question we ask is whether this person is truly stiff or are their muscles guarding as a protective mechanism, limiting range of motion. Often, patients with hypermobility (more flexible joints) have limited range of motion as their nervous system is sending signals to their muscles to guard as a protective mechanism. In these cases, we figure why muscles are guarding and take appropriate action.
In other cases, people have stiffness. This may be due to arthritis or just general hypomobility (lacking joint movement). Often these patients have central and/or one-sided thoracic spine pain and limitations in range of motion that consistently reproduces symptoms. Depending on the cause, treatments include:
- Manual therapy to increase mobility
- Spinal manipulations as a “control/alt/delete” for the nervous system to decrease muscle guarding, reduce pain and improve strength
- Strengthening/motor control (coordination) exercises
- Stretches
- Dry needling to decrease muscle tone
References:
- “Neck Pain Guidelines: Revision 2017: Using the Evidence to Guide Physical Therapist Practice,” Vol. 47, No. 7, 2017, pp. 511-512. Journal of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2017.0507.
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How do we track your progress?
We define patient-centered goals as what you hope to accomplish from physical therapy. While these are typically activity-specific goals, often patients report they just wish to experience less pain.
Benefits of Spinal Manipulation
Spinal manipulations include positioning of a patient and then performing a single, rapid movement to an area of the spine including cervical (neck), thoracic (upper back) and lumbar (lower back).
Physical Therapy for Kyphosis
Kyphosis refers to the normal rounding of the upper back. Occasionally, people will have excessive rounding and in this case the rounding/kyphosis is referred to as hyperkyphosis (hyper = above normal). This rounding increases naturally as we age and there is no standard definition of hyperkyphosis versus normal changes associated with aging. An increase in kyphosis is more common in women than men. The cause of an increase in kyphosis is due to muscle weakness and impairments in flexibility/mobility.