Use of Osteopathic Manipulative Treatment in Alleviating Hypertonic Chest Wall Pain

We present the case of a 20-year-old male patient with no cardiac history coming in for left sided chest pain described as “burning” sensation. On physical exam, it was noted that patient had hypertonic chest wall muscles that were tight and spastic when palpated on the left chest wall. We used Osteopathic Manipulative Treatment (OMT) to help patient relieve hypertonic muscle. We chose to use muscle energy technique (MET) since this relies on reciprocal inhibition with the end result being relaxation of the target muscle.The patient had resolution of chest pain after applying the technique. Although we did not physically measure the lengthening of the pectoralis minor, it was evident that with each successive MET, the patient’s restrictive barrier had increased. Allowing the pectoralis muscle to relax had helped our patient resolve his chest pain.