Is Mid-thoracic Tenderness ?Normal?? Not!
Reference:Reference: Keating L., Lubke C, Powell V, Young T, Souvlis T, Jull G. 2001 Mid-thoracic tenderness:a comparison of pressure pain threshold between spinal regions, in asymptomatic subjects. Manual Therapy 6(1); 34-39
Mid-thoracic tenderness is a frequent clinical finding in patients presenting with various upper quadrant musculoskeletal conditions e.g. Rotator cuff syndromes and headaches
Is this thoracic hypersensitivity a coincidental/normal finding or is it clinically relevant? Should it be addressed by Physiotherapy?
This study analysed 50 asymptomatic volunteers. PA � forces were applied using a pressure algometer (a reliable outcome measure) on four spinal levels C5, T4, T6, and L4.
Result:The sensitivity values increased in a cranial direction?meaning C6 was more tender than T4 and T4 was more tender than T6 and T6 was more tender than L4 in the asymptomatic subjects.
Study Conclusion: This study adds to the normative data on spinal sensitivity and supports the hypothesis that mid-thoracic tenderness relative to the cervical spine is NOT a normal finding in asymptomatic subjects.
Clinical Relevance: Some patients with headaches may benefit from mobilization/manipulation of their mid-thoracic spine. They may also benefit from a self-thoracic mob and taping (Please see examples as written in this report).
Personal Comment:Try this: On your future headache patients, assess central PA?s from T4-T8. Don?t be surprised if you find ?unusual tenderness? at some of those levels.
Posted on: April 04, 2002