title: Chiropractic Management of a Patient With Thoracic Pain and a Stable Thoracic Aortic Aneurysm: A Case Report.
abstract: OBJECTIVE
  The purpose of this case report was to describe chiropractic management of thoracic pain in a patient with a stable thoracic aortic aneurysm.
  
  
  METHODS
  An 89-year-old man presented with axial mid- and upper back pain localized predominantly at the T8 and T1 spinal segmental levels. A review of available imaging revealed a stable aneurysmal dilatation of the ascending aorta, which measured 4.3 cm.
  
  
  RESULTS
  Because the thoracic pain was musculoskeletal in nature and the thoracic aortic aneurysm was stable, mechanical manipulation was provided using the Impulse adjusting instrument. The patient's pain was measured utilizing a numeric rating scale. The patient's thoracic pain improved over the course of treatment.
  
  
  CONCLUSIONS
  This patient was successfully treated for thoracic spine pain with a course of chiropractic care using a mechanical adjusting instrument.
authors.affiliation: Veterans Administration Medical Center, Martinsburg, WV.
authors.forename: Shawn M
authors.initials: SM
authors.lastname: Neff
authors.affiliation: Veterans Administration Medical Center, Martinsburg, WV.
authors.forename: Casey S
authors.initials: CS
authors.lastname: Okamoto
keywords: Aortic Aneurysm; Back Pain; Chiropractic; Manipulation; Spinal; Thoracic