Thoracic Article Review

Louw A, et al. Chronic pain and the thoracic spine. 2017 Why is the mid-thoracic spine considered the "anchoring point" of the dura?

Result in common clinical "pulling" sensation associated with the slump test. This implies that a healthy thoracic spine is needed to allow for optimal movement properties of the highly pain-sensitive dura.

Louw A, et al. Chronic pain and the thoracic spine. 2017 Which nerves in the thoracic spine follow the intercostal spaces:

T2 and below.

Louw A, et al. Chronic pain and the thoracic spine. 2017 The posterior primary rami of the spinal nerves arise at level _______ through ______ and can be injured with hyperflexion resulting in a condition known as bare axolemma and is associated with chronic sensory neuropathy.

T2, T6

Stochkendahl MJ, et al. Chest pain in focal musculoskeletal disorders. 2010. Segmental dysfunction is defined as:

The disturbance of function affecting quality and ROM of spinal segments without structural change.

Stochkendahl MJ, et al. Chest pain in focal musculoskeletal disorders. 2010. Costochondritis is described as:

The inflammation and swelling of costal cartilages.

Louw A, et al. Chronic pain and the thoracic spine. 2017 The nervous system has three requirements:

1. Space 2. Movement 3. Blood supply and produce clinical signs and symptoms when compromised.

Negrini S, et al. 2016 SOSORT Guidelines. 2018. The "critical threshold" for scoliosis is between

30 degrees and 50 degrees.

Louw A, et al. Chronic pain and the thoracic spine. 2017 Central sensitization is defined as:

A condition in which peripheral noxious inputs into the central nervous system led to increased excitability where the response to normal input is greatly enhanced.

Louw A, et al. Chronic pain and the thoracic spine. 2017 What is the main premise behind Graded Motor Imagery (GMI)?

A distortion of body maps in the SI.

Stochkendahl MJ, et al. Chest pain in focal musculoskeletal disorders. 2010. What is the most common diagnosis in primary care for patients presenting with thoracic pain?

Cause of pain may be benign in approximately 80% of cases, of which MSK chest pain accounts for almost 50%.

Louw A, et al. Chronic pain and the thoracic spine. 2017 Chemical activation of the ____________ often results in referred pain to the thoracic spine and is clinically know as Cloward's areas.

DRG

Stochkendahl MJ, et al. Chest pain in focal musculoskeletal disorders. 2010. Tietze syndrome is described as:

The presence of painful swelling of the costal cartilages caused by benign inflammation with the absence of costochondritis.

Lindgren KA, et al. Cervical rotation lateral flexion test. 1992. Describe the performance and interpretation of the CRLF test:

The spine is rotated maximally away from the side to be tested, and is then flexed as far as possible, moving the ear towards the chest. The test was positive if a bony restriction totally blocked t he lateral flexion part of the movement. Subluxation of the first rib at the costotransverse joint may restrict the lateral flexion of the maximally rotated cervical spine. The restriction if felt abruptly.

Maurer E, et al. Long term effects of physical inactivity of thoracic and lumbar disc degeneration. 2020. Describe the long-term effects of physical inactivity on thoracic disc degeneration:

There were significantly worse and more lumbar disc degeneration changes.

Stochkendahl MJ, et al. Chest pain in focal musculoskeletal disorders. 2010. Describe the mechanisms for somatic and visceral chest pain:

Visceral pain is pain from structures including the heart, esophagus, stomach. Whereas somatic includes pain from MSK structures, dermal tissues, and covering of major organs.

Negrini S, et al. 2016 SOSORT Guidelines. 2018. SOSORT experts recommend the following be included when prescribing PSSE:

a. Auto-correction in 3D b. Training in activities of daily living c. Stabilizing the corrected posture d. Patient Education

Negrini S, et al. 2016 SOSORT Guidelines. 2018. What are the three proposed classifications for IS?

a. Chronological b. Angular c. Topographic

Louw A, et al. Chronic pain and the thoracic spine. 2017 What are the three main categories of chronic thoracic pain covered in the article?

a. Hypersensitization of intercostal nerves b. Posterior primary rami nerves mimicking Cloward area c. Mechanical and sensitization issues of the spinal dura in the thoracic spine

Louw A, et al. Chronic pain and the thoracic spine. 2017 It has been shown that myelin can be removed from axons because of three mechanisms:

a. Mechanical (sudden load, scar tissue) b. Chemical (pro-inflammatory products in bleeding c. Disease directly targeting myelin (MS, human immunodeficiency)

Louw A, et al. Chronic pain and the thoracic spine. 2017 What are characteristics of peripheral neuropathic pain?

a. Pain in dermatomes or cutaneous distribution b. Positive neurodynamic test c. Positive palpation sensitivity d. History consistent with nerve pathology or compromise

Louw A, et al. Chronic pain and the thoracic spine. 2017 In neurodynamic, neural tissues may have been affected by:

a. Tension impairment (a problem handing the mechanical load imparted on them). b. Hypersensitive (a problem of pathophysiological changes within them) c. Combination of both

Negrini S, et al. 2016 SOSORT Guidelines. 2018. What are the four basic objectives of comprehensive conservative care for IS:

a. To stop curve progression at puberty (or possibly even reduce it) b. To prevent or treat respiratory dysfunction. c. To prevent or treat spinal pain syndromes. d. To improve aesthetics via postural corrections.