A gentleman walks in with very intense mid-back pain that radiates down his whole spine and into both legs, of four-day duration. He had an appointment the next day but came in today because of the intense pain.

His thoracic spine from T4-8 was subluxated with compensatory bilateral muscle spasms.

Priorities: thoracic segments and ribs as he moved his head in flexion/extension, shrugged his shoulders, and did a meningeal release adjustment. Asked how the pain is. He says: "It's gone, there is nothing now! Four days I suffered, and it's gone."

In my old days of diversified adjusting, he would have been too acute to even work on; maybe 2-3 office visits to treat soft tissue with modalities to cool it down enough to do an anterior dorsal adjustment that would have been painful.