Resolution of Chest Wall Syndrome

13 May

The following are some of my favourite excerpts from a research case study highlighting the improvements while under Chiropractic care that a lady had who was suffering with chronic chest wall syndrome. The research article is titled Resolution of Chronic Chest Wall Syndrome in a 45-Year-Old Female Following Chiropractic Care: A Case Report & Review

We do see patients with similar presentations of chest pain at our office who have had similar experiences as the patient in this study.

What can pain in the chest be from?

Pain in the chest can be from many things as mentioned below. It can be from the heart, lungs, stomach, ribs, sternum, muscles, and stress. The heart and lungs can be emergencies of course which is why it is important to be checked by a Medical Doctor. Chiropractic can directly adjust the sternum and ribs.

Haasenritter et al. found that of 11 eligible studies comprising of pooled patients numbering 6500 patients, the relative frequencies of different conditions as the underlying etiologies of chest pain reported ranged from 24.5 to 49.8% (i.e., chest wall syndrome), 13.8 to 16.1% (i.e., cardiovascular diseases), 6.6 to 11.2% (i.e., stable coronary heart disease), 1.5 to 3.6% (i.e., acute coronary syndrome/myocardial infarction), 10.3 to 18.2% (i.e., respiratory diseases), 9.5 to 18.2% (i.e., psychogenic etiologies), 5.6 to 9.7% (i.e., gastrointestinal disorders), and 6.0 to 7.1% (i.e., esophageal disorders). Clinicians tend to describe chest pain of musculoskeletal origin as separate entities with diagnostic terms like costochondritis, costosternal syndrome, sternalis syndrome, Tietze’s syndrome, rib-tip syndrome or xiphoidalgia and of interest in this case report, chest wall syndrome.”


“The bones in the chest wall include the ribs, sternum and spine. Together with skin, fat, muscles, and other tissues, the chest wall encases vital organs in the area between the neck and the abdomen that includes the heart, major blood vessels, lungs, and liver. Chest wall pain is a common clinical presentation in primary care…”


“Chest wall pain may originate from the ribs, sternum, and spine along with its associated soft tissue elements (i.e., the spine with its joints, ligaments, muscles, fascia, etc.) as well as the encased organs that provide a diagnostic challenge for many clinicians as demonstrated in this case report. The broad spectrum of causes of chest wall pain may span from life threatening diseases to “benign” causes such as rib pain of musculoskeletal origin.”


Who was the patient in this chiropractic study?

“A 45-year-old female presented for chiropractic consultation and possible care with right anterolateral thorax pain that began approximately 2 months prior.”

“Past medical history was noteworthy for mitral valve replacement surgery 2 years prior”
“9 months prior, she was performing housecleaning activities that involved lifting boxes weighing 10 to 20 pounds. Her pain began approximately 3 days after her housecleaning activities and was localized to the right anterolateral thorax area.”

“Her medical doctor advised her that she was suffering from reflux esophagitis and muscles spasms and prescribed Celebrex and Arcoxia, as well as muscle relaxants and Vitamin B complex. According to the patient, these medically prescribed medications were only mildly palliative. She discontinued her pain medications after 3 days of use due to negative side effects.”

“Four months after the onset of her pain complaint, the patient related that her pain complaint had spontaneously abated and she was pain free for two months. However, her anterolateral thorax pain returned following similar housecleaning and lifting activities.”

“The patient described her pain complaint as achy and sometimes sharp with movement provoking pain from a seated or lying position to standing”

The patient had been tested medically and had CT Scans, Specialist examinations, Thoracic spine X-Rays, Full Spine X-Rays. She eventually was suggested to have a gallbladder removal surgery but fortunately improved with the Chiropractic help before that was attempted.


What Chiropractic Care was done?

“the initial working diagnosis was painful rib syndrome in the context of chest wall syndrome secondary to vertebral subluxation.

“Care recommendations were chiropractic adjustments scheduled at 1-2 times per week for a total of 6-8 sessions after which the patient would be re-evaluated.”

“Chiropractic adjustments were also performed (i.e., anterior thoracic move) with the patient reporting an immediate decrease in mid-upper back tension that had been present since her mitral valve replacement surgery.”

“On her 3rd visit, the patient reported an estimated 75% improvement in pain severity and frequency.”

“At 4 weeks follow-up, the patient reported continued pain-free status from her initial complaint. She has elected to receive wellness care visits with chiropractic.”

What did the authors conclude from the study?

“This case report provides an educational vehicle and evidence on the successful chiropractic care of a patient presenting with rib pain. We encourage continued documentation of similar cases in the scientific literature.”

Read more about Rib pain and Chiropractic

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