Costochondritis: Are the symptoms and signs due to neurogenic inflammation. Two cases that responded to manual therapy directed towards posterior spinal structures

Published:March 15, 2007DOI:
      Approximately 50% of patients attending accident and emergency departments and outpatient cardiac clinics because of chest pain have a non-cardiac basis for their symptoms. They are often given a non-specific diagnosis (
      • Mayou R.
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      • Sanders D.
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      A controlled trial of cognitive-behavioural therapy for non-cardiac chest pain.
      • Capewell S.
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      ). One possible diagnosis these patients may receive is costochondritis. Possible causes of costochondritis will be discussed and a group of these patients delineated for whom there is no documented underlying pathophysiology. This paper then presents two such case reports and goes on to question whether costochondritis is simply localised anterior chest wall pathology. It is considered whether positive responses to manual therapy directed towards the spine and posterior rib articulations are indicative of a more widespread neuropathic contribution to the condition.


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