In addition to joint dysfunction, myofascial pain syndrome, and thoracic herniated disc, which have already been reviewed in this article, chiropractic care may be a treatment option for additional upper back problems, such as thoracic joint dysfunction, thoracic outlet syndrome, and shoulder dysfunction related to the upper spine.

Joint Dysfunction

The thoracic spine is a marvel of joint interaction and complex motion patterns. Composed of a total of 220 separate joints,1Cramer, Gregory, Susan Darby. Appendix I. In: Clinical Anatomy of the Spine, Spinal Cord, and ANS, 3rd Edition. Mosby, 2014. vbk:978-0-323-07954-9, page 642. it makes up the lion’s share of the 313 total joints in the entire spine. With this many interactive articulations it is easy to see that maintaining normal joint function, motion, and position is important. Chiropractors treat thoracic joint dysfunction with chiropractic adjustments.

See Chiropractic Adjustment

There are a variety of chiropractic-adjustment techniques that can be used to adjust a dysfunctional joint:

  • Most chiropractors employ manual adjusting techniques that utilize precise thrusting adjustments to help normalize joint function.
  • Chiropractors can also use softer directional adjusting techniques or adjusting instruments to accommodate the needs of the patient.

Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a disorder in which the nerves of the brachial plexus and blood vessels are compressed. This compression can cause great pain and altered sensations such as a “pins and needles” sensation in the hands.

Treatment of thoracic outlet syndrome can include stretching, manual trigger-point therapy, and myofascial anchor-and-stretch release techniques to the affected muscles. Chiropractors may also include adjustments and postural instruction.

Thoracic/Shoulder Dysfunction

The function of the shoulder and the upper back are interrelated.Studies have shown that thrusting manipulations applied to the thoracic spine and ribs have reduced shoulder pain and dysfunction. Chiropractic adjustments to the thoracic region can be beneficial to certain types of shoulder dysfunction.

See Myofascial Release Therapy


There are many causes and treatment options for thoracic spine disorders. Chiropractors have a wide range of treatment options for treating these conditions. Chiropractors are increasingly joining collaborative spinal care teams as a drug-free option for treating spinal and musculoskeletal conditions.

  • 1 Cramer, Gregory, Susan Darby. Appendix I. In: Clinical Anatomy of the Spine, Spinal Cord, and ANS, 3rd Edition. Mosby, 2014. vbk:978-0-323-07954-9, page 642.

Dr. William Morgan is the President of Parker University in Dallas, TX, and a chiropractor with more than 30 years of experience. He previously served on the Board of Trustees of Palmer College of Chiropractic and as a Chiropractic Consultant to the Office of the Attending Physicians at the US Capitol.