Want to Learn How to Relieve Pain Instantly

 

 

Pt. presents w/ chronic thoracic region “sharp pain” that may or may not radiate throughout the ribs/chest. Your 1st diagnostic Intervention

 

A: Rib Springing

B: Order MRI

C: Perform Thoracic Flexion

 

The answer is “A” Rib Springing, here’s why

 

MY CLINICAL REASONING: In diagnostics always rule out what you can rule out right then and there (a lot of times you can deduce what is wrong by process of elimination). I would not order an MRI 1st as it could be a simple costovertebral misalignment that I can simply rib spring to confirm. I would not have the patient perform forward thoracic flexion as a first intervention as chronic “sharp” pain in the back is often mechanical pain.

Mechanical pain in the thoracic would usually be facet dysfunction and/or costovertebral misalignment. The fact that it may be radiating to the front is a tip off that it is either nerve impingement or costovertebral misalignment causing referred pain though the ribs mimicking nerve pain. I can easily rule out if it is costovertebral vs nerve with simple rib springing. If the pain goes away immediately I just confirmed the source of the pain. If I cannot relieve the pain it is most likely nerve impingement.

Just a tip when you see someone who has failed everything with these symptoms it is almost always costovertebral misalignments. I have 3 pts. Right now with insane stories for years of failed interventions, it is sad what they go through and a simple rib springing confirmed to me what the problem was in 10 secs! I just put them on my protocol and watch them get better!