Thoracic Spine Neurology: Impact on Chiropractic Practice
Thoracic pain is less prevalent than low back pain and is generally more difficult to recognize in the clinical setting. Thoracic pain is also more often attributed to serious conditions arising from the thoracic viscera.
As a result, it is often the case that only incidental attention is given to examination, diagnosis and treatment of the thoracic spine, despite the fact that dysfunction in this area can lead to considerable pain and discomfort.
This paper constitutes a review of the literature addressing functional anatomy and neurology as applied to the thoracic spine. The innervation of articular and para-articular structures in the thoracic spine is discussed, leading to further discussion on the unique proximity and contribution of the sympathetic nervous system in innervating thoracic joints.
The authors pose clinical considerations relating to the unique anatomy and neurology of the thoracic spine, in addition to providing a thorough review of the neurology of this area from a chiropractic perspective. Functional anatomy is addressed and related to clinical practice and injury patterns.
There is an abundance of rich sensory innervation throughout the thoracic spine that can contribute to the production of pain. The authors suggest that although the thoracic spine is often overlooked in favor of lumbar and cervical spinal segments (which often show more clearly defined symptoms), this region "may provide one of the more intriguing areas for research and refinement of chiropractic interventions."
Hayek R, Henderson CNR, Hayek AFE. Unique features of the thoracic spine: impact on chiropractic management. Topics in Clinical Chiropractic
, Sept. 1999:6(3), pp69-78.
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