• Title/Summary/Keyword: thoracic pain

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The Benefit of Thoracic Mobilization and Manipulation for Upper Thoracic Pain: A case study

  • Park, Si Eun;Lee, Jun Cheol;Choi, Wan Suk
    • Journal of International Academy of Physical Therapy Research
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    • v.8 no.2
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    • pp.1201-1205
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    • 2017
  • The purpose of this case study was to investigate the effects of thoracic mobilization and manipulation on a patient with upper thoracic pain. The subject had been complaining of upper thoracic pain for the last 4 months. On the X-ray, T3 and T4 spinous process were located on the left side of the vertical axis. First, transverse mobilization was applied from left to right at the T3-T4 and then thoracic manipulation was performed. The intervention methods of mobilization and manipulation were based on the concept of Maitland manual therapy. The subject underwent a total of 20 sessions (five times per week for four weeks). The thoracic pain and vertebral rotation angle were measured to examine the effect of the intervention. The thoracic pain score decreased (from 4.0 to 1.5) and the angle of thoracic vertebral rotation decreased (from $70{\underline{\circ}}$ to $4.0{\underline{\circ}}$). These results suggest that applied mobilization and manipulation in patients with a primary complaint of thoracic pain decreasing the thoracic pain and vertebral rotation angle.

Bipolar Intra-articular Radiofrequency Thermocoagulation of the Thoracic Facet Joints: A Case Series of a New Technique

  • Kim, David
    • The Korean Journal of Pain
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    • v.27 no.1
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    • pp.43-48
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    • 2014
  • Background: This study tests the hypothesis that of bipolar radiofrequency thermocoagulation of the thoracic facet joint capsule may provide a safe and effect method of pain control from thoracic facet origin. Methods: Among patients suffering from localized mid back pain, nine patients with thoracic facet disease confirmed by magnetic resonance image and diagnostic thoracic facet block were enrolled. Bipolar radiofrequency ablation in the inferior aspect of the thoracic facet joint was done. Visual Analog Scale (VAS) was measured pre-intervention and 1 month post-intervention. Any complications and changes in amount of pain medication were recorded. Results: Significant 47.6% reduction in VAS was noted at 1 month. There were no serious complications. Conclusions: Intra-articular bipolar radiofrequency thermocoagulation of the thoracic facet joint may be a technically easier and valid method of treating mid back pain of thoracic facet origin.

The Effect of Thoracic Joint Mobilization on Pain, Proprioception and Static Balance in Patients With Chronic Low Back Pain (흉추 관절가동술이 만성요통환자의 통증, 고유수용감각 및 균형수준에 미치는 효과)

  • Yang, Jin-mo;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.1-11
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    • 2015
  • The purpose of this study was to investigate the effect of lumbar stabilization training and additional thoracic mobilization on pain, proprioception and static balance in patients with chronic low back pain. The subjects of this study were 48 chronic low back pain patients who were randomly allocated to an experimental group 1 ($n_1=16$, lumbar stabilization and thoracic mobilization, thoracic hypomobility), experimental group 2 ($n_2=16$, lumbar stabilization and thoracic mobilization, thoracic normal mobility), and a control group ($n_3=16$, lumbar stabilization, thoracic hypomobility) after a thoracic mobility test. Both experimental groups underwent lumbar stabilization training and additional thoracic mobilization. The control group underwent only lumbar stabilization training. The intervention was performed 3 times per week, 30 minutes each time, for a total of 6 weeks. Thoraco-lumbar joint reposition error was measured using an electrogoniometer and static balance ability was measured using the Tetrax posture analysis system. Subjects' pain level was measured using a 100 mm visual analogue scale. Statistical analyses were performed using a one-way analysis of variance and a paired t-test. Post-hoc testing was carried out with a Bonferroni test. The pain level was significantly lower in both experimental groups compared to the control group. Both experimental groups showed significant reductions in joint reposition error angle (flexion, extension, and side bending) compared to the control group. The static balance level was significantly lower in both experimental groups than in the control group. In summary, lumbar stabilization exercises and additional thoracic mobilization significantly improved the pain level, proprioception, and static balance in patients with chronic low back pain.

Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review

  • Park, Donghwi;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.190-199
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    • 2022
  • Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

Thoracic Sympathetic Ganglion Block for a Patient with Hyperhidrosis (흉부 교감 신경절 차단에 의한 다한증 치료 경험 -증례보고-)

  • Moon, Hyun-Seog
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.139-143
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    • 1995
  • Hyperhidrosis is the state of abnormal sweating on the palm, sole and axillary region. The main treatment of hyperhidrosis are surgical sympathectomy and a thoracic sympathetic ganglion block with neurolytics. Among them, a thoracic sympathetic ganglion block is used in pain clinic for the treatment of hyperhidrosis. I have successfully performed a thoracic sympathetic ganglion block on a 21 year old female patients with pure alcohol. I concluded that the thoracic sympathetic ganglion block was one of the most effective treatment of hyperhidrosis.

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The Effects of Intervention on Thoracic Vertebral Region's Du mai(督脈) and Jia ji xue(夾脊穴) for Shoulder Pain ; 4 Clinical Case Report (흉추부의 협척혈(夾脊穴)및 아시혈(阿是穴)의 처치를 통한 견비통 치험 4례)

  • Lee, In-Seon;Kim, Bong-Hyun;Kim, Min-Kyu
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.1
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    • pp.163-172
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    • 2008
  • Objectives : This study was performed to evaluate the effects of thoracic vertebral region's Du mai(督脈) and Jia ji xue(夾脊穴) intervention on active range of motion(ROM) restricted shoulder pain. Methods : 1. Measurement : The unpleasantness of pain was measured by visual analogue scale(VAS), and ROM was measured by using Goniometer and scratch test. 2. Intervention : Use Acupuncture and bee venom injection in thoracic vertebral region's Du mai(督脈) and Jia ji xue(夾脊穴) that display main tender points. Results : The pain and ROM were improved after thoracic vertebral region intervention. Conclusion : Thoracic vertebral region intervention was effective to active ROM restricted shoulder pain, to reduce the pain and to improve ROM. And this study shows that active ROM restricted shoulder pain and thoracic vertebral region's tender points are connected to each other. Also, region that suggest main tender points previews region of thoracic vertebrae 5-8.

Effects of Thoracic Mobility Exercise Program on Pain, Proprioception, and Static Balance Ability in Patients with non-Specific Chronic Low Back Pain

  • Donghwan Park;Kang-Seong Lee
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.1-7
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    • 2024
  • Objective: The objective of this study was to investigate the effect of the thoracic mobility exercise program on pain, proprioception, and static balance ability in patients with non-specific chronic low back pain. Design: Randomized controlled trial design. Methods: Thirty patients with non-specific chronic low back pain participated in this study. The participants were randomized into the thoracic mobility exercise group (n=15) and the lumbar stabilization exercise group (n=15). Both groups received traditional physical therapy for 30 minutes per session. In addition, the thoracic mobility exercise group and the lumbar stabilization exercise group each exercise 3 times a week for 6 weeks. All participants were measured visual analog scale, proprioception test, and static balance ability before and after the intervention. Results: After 6 weeks of interventions, the thoracic mobility exercise group showed greater improvement in visual analog scale, proprioception test, and static balance ability than the LSE group (p<0.05). Further, the thoracic mobility exercise group had significant Enhancements in all measured variables compared to the baselinetest (p<0.05). However, the lumbar stabilization exercise group had significant improvement only visual analog scale, and static balance ability compared to the baselinetest (p<0.05). Conclusions: Our investigation demonstrates that the thoracic mobility exercise is an effective intervention method for improving pain, proprioception, and static balance ability in patients with non-specific chronic low back pain.

Pulmonary Thromboembolism Presenting with Upper Thoracic Back Pain -A case report- (좌측 상 배부 통증으로 발현된 폐혈전색전증의 증례 -증례 보고-)

  • Lee, Ji Young;Choi, Jin Hwan;Choi, Chang Hoon
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.119-122
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    • 2006
  • Upper thoracic back pain can be musculoskeletal in origin or it could be visceral referred pain, which may be indicative of a serious medical condition. We experienced a case of a 55-years-old female patient who complained of upper thoracic back pain for 1 month, which started 10 days after a traffic accident. She described the pain as being a dull, constant nagging sensation with an intensity of 4/10 on the visual analogue scale. Her pain did not subside after trigger point injection of the rhomboid and trapezius muscles. She reported intermittent palpitation, which indicated that the cardiovascular or pulmonary systems were involved. She was diagnosed with pulmonary thromboembolism by the imaging studies. Refractory upper thoracic back pain should be investigated to rule out this treatable, but potentially fatal condition.

The Immediately Effects of Thoracic Mobilization by Segment on Pain and Range of Motion in Chronic Low Back Pain Patients (분절별 등뼈 관절가동술이 만성허리통증환자의 통증과 관절가동범위에 미치는 즉시적 효과)

  • Sim, Jae-Heon;Jeong, Ui-Cheol;Choi, Hee-Yang;Kim, Cheol-Yong
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.33-42
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    • 2017
  • PURPOSE: This study aims to identify the immediate effects of thoracic mobilization according to segment on disabling low-back pain and the range of motion in patients with chronic low-back pain. METHODS: The participants were divided randomly into two groups: a group (N=12) with pain and disability between the 5th and 9th thoracic vertebrae (T5-T9) and a group (N=12) with pain and disability between the 10th and 12th thoracic vertebrae (T10-T12). The same experiment was conducted in both groups: 10 minutes of thoracic mobilization and 10 minutes of functional massage. The visual analogue scale (VAS) and range of motion measurements were applied to the participants in both groups. All participants were measured again immediately after the program was completed. RESULTS: In both groups, the VAS and range of motion measurements showed statistically significant improvement after the experiment (p<.05). No statistically significant difference was revealed between the two groups (p>.05). CONCLUSION: The results of this study confirmed positive and immediate effects of thoracic mobilization of patients with chronic low-back pain. But, no significant difference in the thoracic mobilization by segment between the two groups. Based on these results, thoracic mobilization could help to improve pain control and functional activity in patients with chronic low-back pain.

Effects of Thoracic Mobility Exercise on Cervicothoracic Function, Posture and Pain in Individuals With Mechanical Neck Pain (등뼈 가동성 운동이 기계적 목통증 환자의 목등뼈부 기능 수준과 자세, 통증 수준에 미치는 영향)

  • Lee, Hwa-jeong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.26 no.3
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    • pp.42-56
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    • 2019
  • Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.