What is the recommended approach to assessing thoracic spine motion clinically?

• A. Assess global thoracic range of motion with flexion/extension and lateral flexion, palpate for segmental stiffness, reproduce concordant pain, and correlate with patient history.
• B. Assess only cervical range of motion to infer thoracic mobility.
• C. Rely solely on imaging; motion testing is not necessary.
• D. Test only thoracic rotation at the upper thoracic levels.

Answer: (A)

Assessing thoracic spine motion clinically should capture how the entire thoracic region moves and how that movement relates to the patient’s symptoms. Start by looking at global thoracic range of motion in the main planes: flexion, extension, and lateral bending, to gauge overall mobility and detect stiffness that spans multiple segments. Then palpate along the thoracic spine to identify segmental stiffness or abnormal tissue restriction, which helps localize the exact levels contributing to dysfunction. A key step is to reproduce the patient’s concordant pain with the motion test—when moving the thoracic region causes the same pain the patient reports, it supports the thoracic spine as the pain source. Finally, interpret these findings in the context of the patient’s history, such as prior trauma, occupation, or repetitive strain, to build a coherent clinical picture and guide treatment decisions. This approach is preferred because it combines functional motion assessment, precise localization, symptom reproduction, and patient history, offering a more complete and clinically meaningful evaluation than relying on imaging alone or on a single plane of motion. Limiting the assessment to cervical ROM, relying solely on imaging, or testing only a single motion plane would miss important aspects of thoracic biomechanics and how they relate to the patient’s symptoms.