The common question posed during the patient encounter: "can chiropractic help pain in XYZ area?" can be applied to many many places but today I want to explore the chest. Pain in the chest obviously raises a lot of alarms about the potential of life-threatening cardiothoracic causes, and those obviously always need to be ruled out before I will look at a patient with acute chest and chest wall pain. But in many cases, I see patient come in who have had a battery of tests and being told with glee that the do not have a heart or lung problem, but not given a lot of options to resolve their pain.
Chest and chest wall pain can come from many know musculoskeletal structures that are treated by chiropractic. Below are my most common culprits.
– Mid cervical disc herniation, spinal nerve compression. The C5 and C6 nerve roots will radiate to the upper shoulder and clavicle. Submit cervical disc herniations for example, or chronic degenerative bony spurs, can trigger a sensation of vague pain in the upper chest. In most instances, patients will have noticed a correlation to neck movement and position.
– Brachial plexus above the clavicle in the scalene muscles. A remarkably common area of problem that's escaping detection. I sometimes joke that I could pay my mortgage alone by working on the anterior cervical spine muscular injuries. The brachial plexus exits between 2 branches of the scalenes, and is remarkably susceptible to irritation or compression between the exit from the spine and the entrance into the axilla. Another 1 of my overused jokes is that there is as much cervical spine in the front as there is in the back. Carefully palpating the neurological structures as they exit the anterior cervical spine can be a bull's-eye for mysterious pain in the shoulder chest and arm. Of all the conditions affecting the chest, this particular 1 is more immediately gratifying since you can often get release of symptoms within 1 or 2 treatments and sometimes right away on the spot.
– Anterior shoulder, especially deep intrinsic protractor muscles like the pectoralis minor and the pectoralis major. The pectoralis minor in particular is known to have trigger points referring to the area underneath the breast. It's a muscle that's often shortened due to postural anterior strain. It's also a muscle that can be pretty easily injured with pushing activities, and certain athletic activities like planks when people decide to become weekend warriors or for the 1st 2 weeks of their New Year's resolution after prolonged couch potato status.
– The costochondral junction: slightly lateral to the breastbone/sternum, the junction of the anterior ribs to the central sternum is through a complex cartilage called the costochondral cartilage. It can get inflamed from systemic inflammatory conditions, and be remarkably painful, even during normal breathing. It's also subject to trauma, especially with compressive rotational forces to the chest. It does respond pretty well to modified adjustments.
– 1 of my all-time favorite, the sternal clavicular joint. I never cease to be surprised how many times it's an issue and how much it's below everyone's radar. The junction of the distal clavicule to the breastbone is actually a fairly complicated join with the meniscal cartilage similar to your knee. The sternal clavicular joint is the last joint in the kinetic chain from the arm to the neck and is often involved in incidents of force transmitted from the arm to the body, such as catching yourself falling on your arm. I also had seen it a fair amount after motor vehicle accidents when people slam into both hands on the steering wheel. Almost as gratifying as the brachial plexus at the scalenes, attempts to respond pretty fast to manual adjustments.
The moral of the story: if you chest pain has been ruled out as not being cardiac or pulmonary in nature, it's worth a chiropractic evaluation.