Mid Back Pain: Joint, Muscle or Nerve? What a Montgomery Chiropractor Checks
Looking for a chiropractor for mid back pain in Montgomery? See how my exam sorts joint, muscle and nerve patterns of thoracic spine pain. Call (334) 997-7463
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If you live with asthma and also have a separate ache in your mid back, ribs or neck, this article explains what a chiropractic musculoskeletal examination assesses. Chiropractic care for asthma sufferers in Montgomery, AL means exactly that and nothing more: care for the musculoskeletal complaints of a person who happens to have asthma. It does not mean that chiropractic treats asthma. It does not.
I am Dr. Elaine McNally, and I have practiced chiropractic in Montgomery for more than 30 years. This article explains what a diagnostic examination at Chiropractic Care Clinic assesses, who may be a candidate for one, and where my role ends and your physician's role continues.
This article is about the musculoskeletal examination: the joints, muscles and ribs of the mid back, chest wall, neck and shoulders. It is written for people who live with asthma and have noticed a separate ache, stiffness or tenderness in those areas.
Chiropractic care is not a treatment for asthma. It does not replace the asthma management plan your physician has given you, and nobody should change or stop that plan because of anything they read here or hear in my office. Decisions about the plan your physician has given you belong to your physician.
Worsening breathlessness needs urgent medical attention, not a chiropractic appointment. Asthma is a serious respiratory condition. If your breathlessness is getting worse, if you have difficulty speaking in full sentences, or if your symptoms are not being controlled by the plan your physician has given you, contact your physician or emergency services right away.
The clinic's how we approach diagnosis first lists this among the conditions patients ask about.
Living with a long-standing respiratory condition can place repeated mechanical demands on the body. Those demands do not come from the airway itself. They come from what the muscles and joints around the chest do in response. Three patterns come up most often in my examination room.
Cough mechanics. A forceful cough is a rapid contraction of the abdominal wall, the muscles between the ribs (the intercostals) and the muscles that pull the ribs downward. Repeated over days or weeks, that effort can leave the rib cage and its attachments sore and guarded, much as a wrist becomes irritated after repetitive work.
Accessory-muscle breathing. The diaphragm is the main muscle of breathing. During difficult periods, many people recruit accessory muscles, meaning neck and upper chest muscles such as the scalenes and upper trapezius that normally have other jobs. These muscles attach to the neck, collarbone and first rib. Worked as breathing muscles for long stretches, they can become tight and tender, and the joints they cross can lose some of their normal motion.
Protective posture. In a difficult period it is natural to sit forward with the shoulders rounded and the head ahead of the body, because that position feels roomier for the chest. Held for hours, it stiffens the mid back, draws the shoulder blades forward and asks the neck to carry a load it was not built to carry.
None of this means the asthma has changed, and a sore rib says nothing about the lungs. It means a body under repeated strain can develop a second, separate problem in the structures around the chest. That second problem is the only one I examine.
The examination is a series of specific tests, and I explain each one as I perform it. Here is what I look at and why.
Together these findings let me build a differential, which simply means the list of possible explanations for a complaint, worked through and narrowed one by one. Pain that changes with turning, bending or pressing on a specific spot behaves differently from pain that does not, and that difference guides the narrowing.
Imaging is never automatic. When the physical examination indicates that a look at the bones is warranted, I use the clinic's in-house digital X-ray. That sequence is what diagnosis-first imaging means: the examination decides whether an X-ray is needed, not the other way around.
A person who may be a candidate: someone whose asthma is stable and physician-managed and who has a distinct, reproducible musculoskeletal complaint. Distinct means you can point to it. Reproducible means a particular movement, position or pressure brings it on the same way each time. Examples are a tender spot between the shoulder blades, a sharp catch along a rib when you twist, or a stiff neck after a long stretch of coughing.
People who are not candidates for this assessment:
If you are wondering what the visit itself involves, what to expect at a first chiropractic appointment in Montgomery walks through it step by step.
Your physician owns the diagnosis and the plan for your asthma. My role is limited to the musculoskeletal findings in my own examination. I ask about your current plan only so that I understand your history, and I never advise changes to it.
If my examination finds a musculoskeletal source for your complaint, I explain what I found, why I think it is the source and what the options are before anything is done. If it finds nothing musculoskeletal to explain your complaint, I say so directly and refer you back to your physician. Hearing that a complaint is not coming from your joints or muscles is a useful finding, because it sends the question to the person equipped to answer it.
I also refer you back, or direct you to urgent care, if anything during a visit concerns me, such as breathlessness at rest, difficulty completing a sentence, or chest pain that does not behave like a joint or muscle problem.
No. Chiropractic care is not a treatment for asthma and does not replace the plan your physician has given you. My examination assesses the joints, ribs and muscles of the mid back, neck and shoulders, and nothing else.
No. Please keep following the plan your physician has given you exactly as directed. If you have questions about it, ask your physician.
Only if the physical examination indicates that imaging is warranted. When an X-ray is needed, it is taken on site at the clinic.
Seek urgent medical attention instead. Worsening breathlessness, difficulty speaking in full sentences, or symptoms your plan is not controlling are medical matters, and the appointment can be rescheduled.
I cannot tell you from a description, which is why the examination exists. Pain that is new, severe or accompanied by breathlessness should be evaluated by your physician first. If my examination finds nothing musculoskeletal, I will say so and refer you back.
Chiropractic Care Clinic is at 2569 Bell Rd, Montgomery, Alabama. To ask about a musculoskeletal examination, call (334) 997-7463 or request an appointment online. Please keep following the plan your physician has given you, and seek urgent medical care for any worsening breathlessness.
