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Chiropractic Research Review

Chiropractic Evaluation of Chest Pain

Triage and diagnosis of chest discomfort and/or pain are vital functions of primary and portal-of-entry professions. From the chiropractic perspective, evaluation of chest pain relies necessarily on patient history and physical examination, since ECG and laboratory studies are not typically available in most chiropractic settings.

Rapid diagnosis of chest pain, whether ischemic or neuromusculoskeletal, is important both for appropriate management and to allay patient perceptions about the problem.

This study was designed to review the health literature regarding the prevalence and characteristics of chest pain, particularly neuromusculoskeletal (NMS) chest pain in the clinical chiropractic setting. More than 100 journal articles and four book chapters were reviewed for this paper. Numerous tables are utilized to present data on various aspects of diagnosis, including:

* the likelihood that chest pain and other symptoms are ischemic in origin;
* thoracic spine inspection and examination;
* provocative examination tests for the thoracic spine and cage; and
* clinical considerations for the thoracic region.

The authors conclude: "Chest pain is a prevalent complaint in primary and portal-of-entry health provider offices, ambulatory care facilities, and urgent/emergent care facilities. ... Chiropractors may provide a diagnosis and care for patients that have been previously overlooked. They may also make a substantial contribution to building much needed scientific and clinical evidence in the diagnosis."

Smith M, Wells K, Ellerbrook M. Diagnosis of chest pain in the chiropractic practice setting: an evidence-based review. Chiropractic Journal of Australia, June 2004;34(2):42-57. www.chiropractors.asn.au/cjournal/cjamain.htm

Chiropractic Research Review

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