The purpose of this report is to discuss the outcome of a patient with non-cardiac chest pain treated with chiropractic spinal manipulation combined with instrument-assisted soft tissue mobilization.


Chest pain is the fourth most common presentation in emergency rooms in the United States. The direct and indirect costs of chest pain are high in terms of disability, medication, repeated hospital admissions and physician visits, and costly diagnostic procedures.

Clinical features

The case of a 45 year-old male presenting to a chiropractic clinic with complaints of chest pain is discussed. Although the source of this chest pain was likely non-cardiac, cardiac risk factors were present and were addressed as well.

Intervention and outcome

The patient was treated with manual thoracic spinal manipulation and instrument-assisted soft tissue mobilization with complete resolution of chest pain at 3 weeks and no chest pain at 1 month and 3 month follow-up visits. Conservative cardiac prevention approaches were encouraged with good outcome.


This case points out the promising role the combination of chiropractic manipulation and instrument-assisted soft tissue mobilization may have in the management of non-cardiac chest pain arising from musculoskeletal dysfunction.

Topics in Integrative Health Care 2011, Vol. 2(3)

Author information: Cooper SR, Pfefer MT. Cleveland Chiropractic College, Kansas,USA.

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