Question
I currently go to a chiropractor once a week. He adjusts my neck and middle to upper back. My neck adjusts fine, but when he adjusts the middle of my back I get a sharp pain in the general area. He changed how he adjusts me, from face down to lying on my back, He places his arm under my back and presses lightly on my chest with my arms folded over in front. It still hurts but it seems to be more controlled with the pressure he applies. I had a cat scan done(The chiropractor's recommendation) and the results did not show any problems. My question is what would cause this pain during the adjustment?

Answer
Dear Marcello,

The pain you experience with the thoracic adjustment can be from any associated anatomical tissue in that area, but the most likely source of the pain is either the muscle tissue that overlies the vertebra or the facet joint of the spine.

Muscle pain is pretty self explanatory, especially if you are tender in that area or have muscle spasms, but facet joint pain may be less so.  The facet joints are oriented in specific planes of motion which allows for the different and distinct ranges of motion from one region of the spine to the other.  For instance, the fact joints in the thoracic spine do not produce much rotation compared the lumbar and cervical spine due to their orientation.  When you get adjusted, the joints can quickly jam together which can compress the cartilage that lines the and result in a sharp pain which is alleviated as soon as the pressure is taken off the spine.  Chiropractors are taught specific adjustments to minimize this, however, it can occur from time to time, and is more prevalent when the joint spaces are inflamed.  This could be the case with you.  If the chiropractor you are seeing tried to thrust upward towards the head, rather than straight down in the spine, it may alleviate this problem by allowing the joint to glide more so than being compressed.  Also, if the pain persists, the chiropractor can adjust that area of the spine with an instrument instead of his hands which should alleviate the pain.

Just make sure that the doctor is aware of your discomfort and ask him to try another technique.
Hope this helps Marcello.  

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net