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Thoracic Opening Thrust (General)

Body Region: Thoracic Spine
Technique Name: Thoracic Opening Thrust Manipulation (General)

Indications: mechanical neck pain (MNP), cervical radiculopathy (CR), thoracic pain, shoulder pain


Patient Position:
  • Supine hook lying, with arms folded across their chest and their head resting on a pillow
Clinician Position:
  • Standing at the side of the patient
Technique Description:
  • Briefly roll the patient toward you and place your hand at the level of the segment to be treated.
  • Your hand should form a fist with the thumb maintained in adduction and the thumb DIP in extension.
  • Place the gutter formed by your fingers (excluding the thumb) and thenar eminence over the spinous process of the level to be treated
  • Return the patient to supine ensuring their weight is fully distributed through the fulcrum you have established with your hand
  • Place your free hand on the patients elbows and tuck their elbows under your axilla
  • Perform a high-velocity, low-amplitude thrust in an anterior to posterior direction
Key Points:
  • You may have the patient perform a deep inhalation and time your thrust with their exhalation to aid in relaxation
  • When you return the patient to supine after establishing your hand position, you may have to "prop" the patient onto your fulcrum by rotating their trunk
  • Evidence

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