Patients with thoracic injuries (including injuries involving the ribs and sternum) may present with a variety of symptoms, including but not limited to; Sharp and/or stabbing pain Dull and/or achy pain Unilateral and/or bilateral pain Pain on inspiration and/or expiration Tightness and/or stiffness and/or restriction   During the patient history and examination, careful consideration should be given to exclude visceral pathology that may present as somatic pain.   Common injuries presenting to a Chiropractor for assessment include; Thoracic disc injuries Thoracic facet also known as zygapophyseal joint strain Costotransverse and/or costovertebral joint strains Functional and structural scoliosis management Intercostal muscle and connective tissue strains Sternocostal joint strains Diaphragm tightness Neural tissue irritation   Thoracic injury predisposing factors; Flexion based lifestyles (upper and lower crossed syndromes) Structural development changes (military spine, sway-back spine, kyphoscoliosis spine) Bone density (osteoporotic compression fractures commonly seen in the elderly and frail who may present with Barrel chested, pectus excavatum and pectus carinatum Paradoxical breathing (chest breathing instead of diaphragmatic breathing)