Chest and midback pain, Part 2: Chiropractic topics

Costochondritis is a condition that causes pain in the front of the chest. This condition effects the middle ribs close to the sternum. Usually this condition produces pain on both sides of the chest. The cause is often difficult to determine but may be associated with some type of injury. Chiropractic traction of the ribs may be effective in reducing pain from Costochondritis. Moist heat and over the counter analgesics are helpful as well.
Slipped ribs are a condition that results from a lifting maneuver such as a bench press motion. A popping or clunking sensation in the lower ribs is often present. The rib may pop in and out during certain motions. The condition is usually caused by loosening of the cartilage of the lower ribs due to direct trauma or constant overcontraction of the chest muscles. Avoidance of the causative motion and rest is recommended.
Fibromyalgia is a common cause of rib pain that is more common in women. Fibromyalgia often produces aching, fatigue and a stiff sensation in multiple muscle groups. Cold, damp weather, fatigue, sedentary positions, overexertion, stress, and poor posture seem to aggrevate the condition. Conservative approaches to fibromyalgia include heat, moderate execise and stess reduction.
Intercostal neuritis is a condition that produces a band of pain on one side of the chest. Intercostal neuritis may be associated with shingles. For persons with shingles the pain is followed by a rash along the nerve distribution path in 3-5 days. Rib subluxations are often the cause of intercostal neuritis as well. Chiropractic adjustments are often very effective in reducing rib subluxations and intercostal neuritis. Chiropractic adjustments of the ribs are also recommended for those with diabetic associated intercostal neuritis.
Pleurisy is often associated with recent respiratory infections. The pain is often made worse by coughing, sneezing and bending of the back. The pains are usually sharp and aggrevated by lying down on the painful side. Chest x rays are often valuable in determining the extend and severity of the condition. Less severe cases are often managed with conservative methods.

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Chest and midback pain: Chiropractic topics

Chest pain is often a indicator of heart problems and may require immediate medical attention. Other types of pain in the chest and midback are not associated with the heart and may be treated with Chiropractic care and other conservative measures.
Muscle strain in the chest is usually the result of a single or repetitive overuse which may result from lifting something heavy or working. The most effective Chiropractic technique for treating strain of the chest muscles is myofascial or trigger point work.
Rib fractures in adults usually result from a direct blow to the chest or a fall onto the chest. The most common area of the ribs that may fracture is on the sides of the ribs to the back. In healthy adults a direct trauma is needed to break the ribs. In the elderly or persons with osteoporosis, minor event may fracture a rib. In some cases the rib may be partially fractured and be referred to as a cracked rib. Rib fractures usually result in difficult and painful breathing and diffucult in lying on the back. Multiple rib fractures usually require immediate medical attention but cracked ribs or small single fractures can be managed conservatively with rest, pain medication, and avoiding sleeping on the back/laughing/sneezing. Rib fratures may cause pain for about 1-2 months.
Tietze’s syndrome is a condition that often effects woman over 50 years old. This condition is known to cause moderate or severe pain on the upper part of the chest on one side. Usually on the second to third ribs. The cause of the condition is unknown but may be inflammatory in nature. In some cases there may be some history of over exertion or coughing. Chiropractic care may be effective in treatment of this conditioin. In persons who cannot get relief from Chiropractic care, medical care can be effective.

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Rotator cuff pain and Shoulder impingement: Chiropractic topics

Tears of the rotator cuff are a common shoulder injury that may result from a fall or traumatic event such as lifting a heavy akward object. Persistent weakness of the shoulder is the most common symptom of a tear of the rotator cuff. MRI is the primary method of evaluating for a true tear of the rotator cuff. For acute injury of the rotator cuff with weakness, MRI may be a first step in managment.
Pain in the shoulder that does not involve an actual tear of the tendons of the cuff is known as shoulder impingement. The condition is also sometimes called bursitis of the shoulder. Impingement of the shoulder is a common condition in people who work with arms overhead or in sports which require overhead motions (swimming, throwing). In this condition the tendons of the rotator cuff become impinged on the collar bone. Additionally, the biceps tendon may be a source of pain in impingement. Some people are more prone to shoulder impingement due to arthritic changes on the AC joint or oddly shaped collar bones.
MRI is generally reserved for persons who are not responsive to conservative care for several months.
Chiropractic management of shoulder impingement involves myofascial release of the tendons of the rotator cuff as well as exercises for the rotator cuff.

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Pain between the Shoulder blades: Chiropractic topics

One of the most common complaints of those who sit at a desk or computer for a living is pain between the shoulder blades. Usually the pain is described as a constant aching pain in the middle and upper part of the back. The pain is usually relieved by activity and made worse by working at a desk.
The imbalance of the muscles of the chest and back are a contributor to this type of back pain. Most working positions at a desk or computer emphasize a hunched position with the head bent forward. This position causes shortening of the muscles of the chest and weakening of the muscles of the back. Some persons who work for years at a desk may even show an accentuation of the curve of the mid back in what is called a hyperkyphosis (or hump back). Often the muscles of the upper back will be tight and tender with trigger points present in the trapezius, chest and shoulder blade musculature. Trigger point therapy or myofascial release technique is one of the most effective Chiropractic techniques in dealing with trigger points of the upper back. The general recommendation for Chiropractic care of pain in the mid back involves a two week plan of care with Chiropractic adjustments and myofascial trigger point therapy at a frequency of three times per week. If the relief is not achieved by the end of the first week of Chiropractic treatment often a second series of treatments is effective. Acupuncture is often highly effective as well in dealing with trigger points of the upper back and shoulders and is often effective in persons who do not achieve full recovery with Chiropractic methods.
Long term prevention of this condition involves stretching of tight pectoral muscles conbined with strengthening of the muscles of the back. Rowing type motions or lifts are often effective. Stretching on a gym ball is also effective for some people. Modification of the work environment is also helpful to avoid irritating postures.
Dr. Tom Etter is a Chiropractor with over ten years of practice experience. Etter Chiropractic serves Olathe, Kansas, Lenexa, Kansas and Overland Park , Kansas and provides treatment for back pain, neck pain, shoulder pain, whiplash and acupuncture.

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Back Pain, pregnancy and Chiropractic

Lower back pain is common in pregnant women. Chiropractic is known to be a safe and effective treatment for back pain in pregnant women. One of the main considerations in Chiropractic care of pregnant women is avoiding any type of pressure on the abdomen. Some Chiropractic tables are equiped with breakaway sections that can accomodate pregnant patients up to a certain point after which lying face down is not possible. Avoiding prolonged lying on the back is also an important consideration in the comfort of a pregnant patient. In the last trimester sacral mobility is an important consideration and trigger point therapy my also be very effective.
The increasing forward weight position of advancing pregnancy causes changes in the curvature of the spine which may irritate the joints of the lower back and cause pain to radiate down the leg. Additionally, the forward weight position may add stress to the musculature of the neck and shoulder area. Stretching of the muscles of the chest in conjunction with stengthening of the muscles of the back and shoulder blade are often an effective combination.
Dr. Etter is a Chiropractor with over ten years of practice experience. Etter Chiropractic serves Olathe, Kansas, Lenexa, Kansas and Overland Park, Kansas.

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