Osteopathic Manipulative Treatment: Counterstrain/FPR Procedure - Thoracic Vertebrae

Upper back and neck pain caused by somatic dysfunctions of the thoracic spine are extremely common. Common causes include postural changes and injuries. A viscerosomatic response can also cause somatic dysfunctions. For example, patients who present with chest pain may have an underlying cardiac issue and, therefore, might have a corresponding somatic dysfunction at the level of T1-T5 of the spine. There are a variety of osteopathic manipulative treatments (OMT) for somatic dysfunctions. Indirect osteopathic techniques can frequently treat dysfunctions. Strain-counterstrain (SCS) and Functional Positional Release (FPR) are commonly used indirect techniques. These methods require the clinician to passively take the patient into a position of ease or away from the restrictive barrier. SCS involves placing the patient where the target muscle is shortened, which allows the vertebrae to return to its proper position. FPR uses components of SCS and a functional method with the addition of an activating force (compression or torsion). We discuss these 2 osteopathic techniques to treat somatic dysfunctions of the thoracic spine.