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Lung Function

A common response some patients have following a thoracic (mid-back) adjustment is “I feel like I can breathe better.” This is particularly heard if the patient has recently been battling a cough or some other respiratory ailment. How can this be if all that happened was an adjustment to the mid-back?

The thoracic spine is made up of 12 vertebrae and each of those bones is connected to at least one pair, and in some instances, multiple pairs of ribs. The ribs protect your lungs, which are responsible for allowing you to breathe. One way to measure how well the lungs are working is via pulmonary function testing (PFT). These tests evaluate how much gas your lungs can exchange over certain periods of time. One recent study showed that pediatric patients with asthma displayed increased PFT scores (specifically FEF 25-75%, FVC, and FEV1) when treated with adjustments compared to those who belonged to the usual medication care group (1). Another study looked at patients with Chronic Obstructive Pulmonary Disease (COPD) and found that patients who received both manipulation and conventional drug therapy significantly improved their PFT scores in all areas compared to those who solely received the usual drug therapy, similar to the pediatric asthma study previously mentioned (2).

When you take a breath, your lungs fill up with air and your rib cage moves upward to accommodate the increased volume of the lungs. Then when you exhale lungs shrink in size and in unison the rib cage relaxes and moves downward. Optimally, this is how the process should work, however if there is a vertebral subluxation in the thoracic region, the mechanics of respiration may be dysfunctional. A person might feel like they cannot breathe as deeply or never fully exhale, and in some instances it might be painful. Chiropractic adjustments look to correct mechanical dysfunctions, and by restoring proper biomechanics within the thoracic region, a patient may feel as if they can breathe better afterwards if their thoracic spine and rib cage were not functioning properly.


  1. Jones, L., Regan, C., Wolf, K., Bryant, J., Rakowsky, A., Pe, M. & Snyder, D. (2021). Effect of osteopathic manipulative treatment on pulmonary function testing in children with asthma. Journal of Osteopathic Medicine, 121(6), 589-596.

  2. Buscemi A, Pennisi V, Rapisarda A, Pennisi A, Coco M. Efficacy of osteopathic treatment in patients with stable moderate-to-severe chronic obstructive pulmonary disease: a randomized controlled pilot study. J Complement Integr Med. 2019 Aug 23;17(1):/j/jcim.2019.17.issue-1/jcim-2018-0128/jcim-2018-0128.xml. doi: 10.1515/jcim-2018-0128. PMID: 31442204.

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