Upper thoracic spine dysfunction

**boneill** · 12-06-2008, 02:49 PM

A question for the group
I see a lot of patients with head and neck pain in my practice. I have seen several patients recently with chronic lateral neck and shouldler pain, usually a constant ache with burning type feeling down to the medial scapular border. A common finding seems to be significant restriction of upper T spine motion, usually flattened position at rest, or even one with a reversal of the thoracic curve.
Does anyone have any thoughts on the mechanism or suggestons for treatment approach?
Thanks
Bryan

**Diane** · 12-06-2008, 03:03 PM

What have you tried so far?
What possibilities have you entertained already?

**marcel** · 12-06-2008, 06:51 PM

Hi,

A restriction of upper T spine motion has direct influence on shoulder-arm mobility. Perhaps this can be a cause for relevant nerves to move differently and become "irritated".
I had some astonishing (good) results in using Mulligans technique "snags & nags". For example when abd./elevation is painfull the same movement combined with manual pressure on the homolat. (sometimes the contralat.) side of C5-6 (a kind of manual rotation "impuls") mostly becomes non-painfull and free.

Explanation for this might well be stimulation of rami cutaneii.
I have no proof for this but had many good results.

12-06-2008, 02:49 PM	#1
boneill SomaSimpler Join Date: Apr 2007 Posts: 102 Thanks: 11 Thanked 0 Times in 0 Posts	Upper thoracic spine dysfunction A question for the group I see a lot of patients with head and neck pain in my practice. I have seen several patients recently with chronic lateral neck and shouldler pain, usually a constant ache with burning type feeling down to the medial scapular border. A common finding seems to be significant restriction of upper T spine motion, usually flattened position at rest, or even one with a reversal of the thoracic curve. Does anyone have any thoughts on the mechanism or suggestons for treatment approach? Thanks Bryan

12-06-2008, 03:03 PM	#2
Diane Human Primate Social Groomer and Neuroelastician Join Date: Mar 2004 Location: Weyburn Sask. Posts: 19,678 Thanks: 1,493 Thanked 3,199 Times in 1,571 Posts	What have you tried so far? What possibilities have you entertained already? __________________ Diane www.dermoneuromodulation.com SensibleSolutionsPhysiotherapy HumanAntiGravitySuit blog Neurotonics PT Teamblog Diane Jacobs.com (personal website) Canadian Physiotherapy Pain Science Division (Archived newsletters) Canadian Physiotherapy Association Pain Science Division Facebook page @PainPhysiosCan WCPT PhysiotherapyPainNetwork on Facebook @WCPTPTPN Neuroscience and Pain Science for Manual PTs Facebook page @dfjpt SomaSimple on Facebook @somasimple "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

12-06-2008, 06:51 PM	#3
marcel SomaSimpler Join Date: Feb 2006 Location: The Netherlands, Amsterdam Posts: 275 Thanks: 22 Thanked 34 Times in 10 Posts	Hi, A restriction of upper T spine motion has direct influence on shoulder-arm mobility. Perhaps this can be a cause for relevant nerves to move differently and become "irritated". I had some astonishing (good) results in using Mulligans technique "snags & nags". For example when abd./elevation is painfull the same movement combined with manual pressure on the homolat. (sometimes the contralat.) side of C5-6 (a kind of manual rotation "impuls") mostly becomes non-painfull and free. Explanation for this might well be stimulation of rami cutaneii. I have no proof for this but had many good results. __________________ Marcel "It's a poor sort of memory that only works backwards". Lewis Caroll

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