Treating chronic chest pain with chiropractic instruments

In February 2003, a study was published in the Journal of Manipulative and Physiological Therapeutics outlining the positive effects that “mechanical force, manually assisted short-lever chiropractic adjustment of the thoracic spine.

In particular, the costosternal articulations” had on a 49-year-old male patient who was experiencing chronic chest pains to the point where they were affecting not only his job, but his basic physical movements. After just 14 weeks of treatment, the patient had “complete resolution” of his chest pains, alleviating the negative impact they had once had on his life.

This type of positive finding is just one of many as multiple experts in the field have weighed in on the benefits of chiropractic care when it comes to alleviating non-cardiac chest pain. For instance, in 2011, Mark T. Pfefer, DC, RN, MS, director of research and professor at Cleveland University-Kansas City, co-authored a case report published in Topics in Integrative Health Care, sharing how just three weeks of “manual thoracic spinal manipulation and instrument-assisted soft tissue mobilization” alleviated a 45-year-old patient’s chest pain in its entirety.

And in a recent interview Pfefer explained that “a number of chiropractic techniques can be employed to treat non-cardiac chest pain.”

Alleviating non-cardiac, chronic chest pain

“Chiropractic manipulative therapy including both manual and instrument-assisted techniques can be employed along with soft tissue release to address myofascial issues,” says Pfefer. “Along with spinal targets, the ribs can be adjusted to provide relief for patients with non-cardiac chest pain.  I have seen patients who have had chest surgeries with ongoing chest pain who have responded well to these approaches, with likely pain associated with surgical trauma and soft tissue scarring.  In these post-surgical patients, gentle, instrument-assisted manipulation combined with instrumented soft tissue mobilization have been very effective.”

As indicated in the previously mentioned studies, Pfefer says that, “patients with non-cardiac chest pain often feel better quickly (within a few visits) with chiropractic care when their pain is due to restricted spinal joints, ribs and soft tissue.”

There are also a few things that patient can do at home to help improve his or her healing.

For instance, Pfefer says, “Patients with non-cardiac chest pain should be encouraged to exercise. Walking is very good and the patient should be encouraged to let the arms swing naturally while walking. Extension stretching of the thoracic and cervical spine are also helpful. Improved posture is helpful.  Patients should avoid prolonged sitting.”

Ruling out cardiac conditions

However, prior to implementing these types of techniques and patient care strategies, Pfefer stresses that, “Any patient presenting with chest pain should be assessed for the presence of possible cardiac conditions.  There should be a review of history including prior history of cardiac or pulmonary problems and family history of cardiac issues.  Blood pressure should be assessed.  Signs of cardiac problem may include chest tightness, pressure or pain; pain in the arms, jaw, stomach, shoulders, or face; sweating; fatigue; shortness of breath; feeling of upper stomach pain or complaint of ‘indigestion’; nausea or vomiting.”

He goes on to say that “medication and drug use should be assessed.  Cardiac risk factors should be assessed.”

This is critical, Pfefer says, as “time is of the essence and suspicion of cardiac problem or myocardial infarction should prompt immediate referral to the nearest emergency department.  If an active myocardial infarction is suspected, the patient should be transported by ambulance.”

“Once cardiac causes are ruled out then other potential causes should be considered,” says Pfefer. These include “gastroesophageal reflux and musculoskeletal causes.  Stress and depression may play a role in chest pain as well.”