Chest Pain, Mid-Back Pain and Chiropractic
A report on the scientific literature
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
Chiropractic care is targeted to reducing the Vertebral Subluxation Complex and associated neuro-muscular conditions after more serious medical conditions have been ruled out with chest pain. Vertebral Subluxation Complex is the most common reason for pain in the middle back and chest that is not the result of a heart problem or acid reflux. In cases of non-cardiac (not involving the heart) middle back and chest pain, Chiropractic has been shown to have significant results in reducing or eliminating pain and discomfort. Many people experience pain between the shoulder blades, over the breast bone or the collar bones. In today’s society of increasing demands in the office setting, endless hours in front of a computer or all day commutes in our vehicles the stress on the thoracic spine (middle back)and chest continues to increase. Unfortunately when we sit and slouch forward, the brunt of the forces are condensed to the area just below our shoulder blades and our breast bone. We have all been cautioned to “have good posture”, but anyone that has worked a full day knows, once you are tired there is really not much you can do about your posture.
A recent study stated that “Traditionally, patients with chest discomfort are admitted to a cardiology ward because the heart is under suspicion as the pain source; however, the etiology of pain may be non-cardiac in up to 50% of cases”1 (p654). The authors continue on to say “Although patients with non-cardiac chest pain have an excellent prognosis for survival and a future risk of cardiac morbidity [complications] similar to that of the general population, approximately 3 quarters of these patients continue to suffer from residual chest pain, one half remain or become unemployed, and one half report being significantly disabled”1 (p 654)
The most important aspect of this study states “There is a broad agreement among clinicians that the musculoskeletal system is a potential source of pain in non-cardiac chest discomfort, but very few studies have addressed this issue systematically despite the compelling issues discussed above.”1 (p 654) This study found that there was a significant reduction in the anxiety associated with the patient’s chest pain, the patients had a better understanding that the musculoskeletal system was the source of their discomfort and 96% of patients believed that chiropractic treatment had helped.1
In a case study published in 2003, the authors discovered that after the possibility of cardiac involvement was considered, Vertebral Subluxation Complex located at the junction of the breast bones and ribs in the front of the chest was the cause. Reducing the Vertebral Subluxation Complex with Chiropractic techniques had resolved this patients symptoms. 2
Chiropractic interventions into managing and/or eliminating chest and middle back pain have been shown to be safe once cardiac causes have been ruled out. Doctors of Chiropractic are trained to not only evaluate for non-musculoskeletal conditions, but to work as part of your healthcare team. 3
1. Henrik W. Christensen, DC, MD, PhD, Werner Vach, PhD, Anthony Cichangi, Claus Manniche, MD, DMSc, Torben Haghfelt, MD, DMSc, and Poul F. Hilund-CaHsen, MD, DMSc. Manual Therapy for Patients with Stable Angina Pectoris: A Nonrandomized open prospective trial. J Manipulative Physiol Ther 2005;28:654-661
2. Bradley S. Polkinghorn, DC, Christopher J. Colloca, DC. Chiropractic management of chronic chest pain using mechanical force, manually assisted short-lever adjusting procedures. J Manipulative Physiol Ther 2003;26:108-15.