tietzes syndrome

by Larry
(Towne Lake Georgia)

I am a chiropractor in Georgia and recently a 55 yo female presented with acute onset sternal pain that occurred from a chiropractic adjustment
that she received while laying prone from a chiropractor.

There is pain on most movements especially bending forward to lift and deep inspiration. I read about only using anteriority type cmt and sternal massage at the sternal attachment. Are there more treatments or techniques you can recommend for this condition. Many professional thanks!

Good morning Dr Larry,
Iatrogenic illness doesn't just pertain to medicine, eh! I'm afraid I've caused this too with heavy P to A adjustments, hence my particular interest in the subject.

Lying supine, palpate the costosternal rib attachments; locate the painful rib. Compare with it's brother on deep inspiration and expiration. Is there a lag on the painful side?

With the patient lying on the side, painful rib up, circumnavigate the rib with the third fingers on the sternal and spinal attachments, and the thumbs in the MAL. Mobilise in the direction of fixation with appropriate inspiration or expiration. Remove hands during opposite phase of breathing in case of female. Best have another person present.

Deep soft tissue therapy along the offending intercostal space.

Reassure the patient it'll get better. It will.

Sometimes you'll get a swollen node over the sternal joint. Ice it.

Let me know how you get on; I hope this contributes.

If you find these newsletters helpful, by all means forward to patients, adding your name but obviously giving Chiropractic Help credit.

Dr B

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