The Effectiveness of Noninvasive Interventions for Musculoskeletal Thoracic Spine and Chest Wall Pain: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

Abstract

Quality evidence on the management of musculoskeletal thoracic pain is sparse. The current evidence suggests that compared to placebo, spinal manipulation is associated with a small and clinically nonimportant reduction in pain intensity and that acupuncture leads to similar outcomes as placebo. Furthermore, a multimodal program of care (ie, manual therapy, soft tissue therapy, exercises, heat/ice, and advice) and a single education session lead to similar pain reduction for recent-onset musculoskeletal chest wall pain. However, patients who receive multimodal care are more likely to report pain improvements.

Spine Care as a Framework for the Chiropractic Identity

“…It is natural for patients who have had a positive experience with chiropractic care for a spine problem to seek out the same practitioner when they develop a problem in another area of the musculoskeletal system. There is in fact good evidence that chiropractors can be helpful in managing headaches,57, 58 musculoskeletal chest pain,59, 60, 61 osteoarthritis of the hip, 62 and a range of other musculoskeletal conditions 63 …”

The risk associated with spinal manipulation: an overview of reviews

“…Some of these reviews further specified SMT as cervical, thoracic or lumbar SMT (21 reviews [46, 47, 49, 54, 57, 65, 91, 96, 103, 105, 114, 115, 119, 121, 123, 125–127, 134, 136, 150]). Other reviews did not further specify than ‘manipulation’ (10 reviews [36, 66, 70–73, 79, 93, 101, 107]), ‘osteopathic manipulative treatment/therapy’ (8 reviews [38, 52, 56, 64, 81, 82, 116, 139]), and ‘chiropractic care/interventions’ (5 reviews [67, 98–100, 137]).…”

Understanding symptom experiences of muscle tightness from patients’ and clinicians’ perspectives

“…Medications play a role in the management of muscle tightness (Bhimani , Southerst et al . ), but it is the support and education offered as part of individualised plans that can optimise quality of care. Nurses play a key role in managing symptom experiences in any setting.…”

“…Nurses often manage muscle tightness through heat, ice and stretching interventions (Southerst et al . ). Oftentimes, patients may elect to manage these conditions at home.…”

“…Muscle tightness may interfere with functional movements, hinder independent performance of activities of daily living and cause pain and insomnia (Bhimani 2008). Nurses often manage muscle tightness through heat, ice and stretching interventions (Southerst et al 2015). Oftentimes, patients may elect to manage these conditions at home.…”