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Chiropractic Research Review

Assessing Thoracic Spine Pain

The relative rarity of thoracic disc herniations in the general population, and the lack of a clearly defined set of common symptoms, can pose a challenge in deriving a clinical diagnosis of this disorder.

The tendency for these lesions to mimic numerous other conditions, including cardiac, gastric and esophageal disorders, necessitates careful clinical evaluation and differential diagnosis.

This literature review and clinical commentary discusses appropriate identification and management of thoracic disc herniations. Informative tables are presented listing potential clinical findings and their interpretations as they relate to thoracic disc herniation. Also included are discussions of:

* Evaluation procedures;
* differential diagnosis considerations;
* diagnostic imaging options; and
* conservative treatment protocols.

The author notes that magnetic resonance imaging (MRI) is unable to differentiate symptomatic from asymptomatic herniations, emphasizing the value of careful history and examination. He also suggests that "failure of cervical, lumbar or extremity symptoms to respond to treatment as expected should cause thoracic disc herniation to be considered."

Note: This paper is presented in a clinician-friendly manner. It takes the reader step by step through the patient encounter, discussing a number of important issues and examination procedures that can be applied immediately in practice.

Lamb KL. Thoracic disc herniations. Topics in Clinical Chiropractic, Sept. 1999:6(3), pp39-48.
Reprints: (800) 638-8437

Chiropractic Research Review

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