Patterns of pain induced by distending the thoracic zygapophyseal joints

Short-Term Combined Effects of Thoracic Spine Thrust Manipulation and Cervical Spine Nonthrust Manipulation in Individuals With Mechanical Neck Pain: A Randomized Clinical Trial

“…Second, the literature has documented the relationship between pain-referral patterns of the facet joints of the cervical and upper thoracic spine. 25,26 Thoracic spine thrust manipulation may alter the sensitivity of mechanoreceptors and subsequently alleviate neck pain through alteration of these pain-referral patterns. 3 We recognize that a variety of other manual therapy techniques are used daily in clinical practice to manage neck pain.…”

Treatment of Chronic Painful Musculoskeletal Injuries and Diseases with Regenerative Injection Therapy (RIT): Regenerative Injection Therapy Principles and Practice

“…Local anesthetic diagnostic blocks are still the best available objective con fi rmation of the precise source of pain in clinical diagnosis [ 3,4,[11][12][13][14][15][16][17][22][23][24][25] . [ 4 ] , ( c ) by Dussault and Kaplan [ 5 ] , and ( d ) by Fukui et al [ 6 ] . Signi fi cant resemblance of the pain patterns and their overlaps is due to the fact that injected structures receive the same segmental innervated by the thoracic dorsal rami speci fi cally the medial branches (MBDR)…”

Musculoskeletal Imaging in Physical Therapist Practice

“…Although any detailed discussion of referred pain is beyond the scope of this article, there is general consensus that symptoms can be referred remotely from the origin of pathology, that pain can be referred from both somatic and visceral structures, and that palpation tenderness may indeed exist in the area of the referred pain. 2,23,[33][34][35]41,62,66,73 Diagnostic studies of referred-pain locations are likely to reveal only irrelevant pathology or appear normal. Careful planning and execution of the patient/client examination based on the unique presentation of each patient, with full consideration of the possibility of referred pain, will help reduce such examination errors.…”

“…50 Because the upper aspects of these spinal regions are known to refer symptoms distally, the potential exists to mistakenly correlate asymptomatic pathology at lower spinal levels with the pain that is being referred from higher spinal levels. [33][34][35] Sometimes the more obvious or more symptomatic area obscures the need for imaging of other injuries or pathology. Common examples include ankle sprains accompanied by foot fractures and lower extremities fractures accompanied by spinal fractures.…”