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Thoracic Back Pain – APM

Thoracic back pain is pain, discomfort and stiffness in the mid to upper back at the level of the

spinous processes T1-T12. Patients can experience pain between the shoulder blades and in

the muscles surrounding T1-T12.

Sources WWW.triggerpoints.net

Acupuncture Physic al Medicine by Mark D. Seem

Acupuncture Osteopathy by Mark D. Seem

Acupuncture Imaging by Mark D. Seem

PATTERNS OF DISHARMONY/DIAGNOSIS (Faces of Fatigue; Zone or TM

Dysfunction Spinal Irritation

Clinical Manifestations Pain/discomfort/stiffness in the thoracic area

PALPATORY FINDINGS Tightness and constriction in the major muscles of the upper and middle dorsal zone:

Trapezious

Rhomboids

Para spinals

Subscapularis

levator Scapulae

TREATMENT PRINCIPLES: Disperse Tai Yang Zone Excess/Du Mo Excess; Regulate Kidney/Heart Protector Meridians

TREATMENT PLAN: A) Jing Level:

BL62 opens Yang Qiao Mai

SI3 opens Du Mo

B) Ying Level:

KD3 + BL 58-source and luo points that complete the internal/external circuit

BL23- Kidney shu point

C) Wei:

Thoracic Back Pain - Acupuncture PhysicalMedicine

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Bl40- Command point for the back

Bl63- xi cleft point for the bladder channel

*Trigger points and ashi points local to the area and along the affected channels

The patient is first needled at the jing level using the Du Mo and Yang Qiao Mai. This opens up

the dorsal/tai yang zone. At the ying level, the source/luo of the KD and HT complete the Tai

Yang-Shao Yin circuit. The shu points, most powerful for the organs being located right abovethem, affect the corresponding organs. The Wei level points deal with any myofascial

constrictions, bring blood and qi back to those areas, relieve symptomatic pain, and allow the

muscles and their mytotic units to function properly again. By allowing the musculature of the

back to relax the practitioner is alleviating pain symptoms and alerting the client to holding

patterns. Trigger point dry needling leaves a soreness that will be a constant but temporary

reminder of where to relax in the future.

PATIENT EDUCATION/RECOMMENDATIONS: If pain was caused by an injury the patient should do qi gong exercises to strengthen the area

so that future injury can be prevented. This is important since atrophy of muscles has started

to happen due to injury. If the pain was cause by tight muscles than the patient needs to learnto relax by: 1. Watching his posture when sitting/standing, 2. Aerobic exercise 3-4x a week for

a half hour, 3. Do qi gong exercises specific to the area that is tight. Patients should come for

one treatment every week for 3 or 4 weeks and then once a month for follow-ups. If this

prescription does not improve the patient’s condition it is recommended to him to consult his

primary care physician.

Prognosis: Regular exercise, acupuncture treatments and/or stopping/limiting activities that caused injury

can get rid of pain symptoms. Patients must be mentally vigilant and pay attention to posture,

what activities they did to cause pain and seeing if they get enough exercise.