Abstract
Introduction: Chest pain (CP) is a common and challenging complaint in the emergency department (ED), often requiring rapid assessment to rule out serious conditions. While medication-based treatments are frequently used, there is a growing need for alternative therapies, particularly for non-cardiac chest pain. The sternal brace, an osteopathic manipulative technique, may serve as an adjunctive therapy for chest pain in the ED. Objective: This prospective observational cohort study aimed to explore the effect of the sternal brace maneuver in reducing CP of any etiology in ED patients. Methods: Data were reanalyzed from 34 adult patients presenting with CP at Newark Beth Israel ED. The Numerical Rating Scale (NRS) was used to measure pain levels before and after the maneuver. Patients were classified as responders if their NRS decreased. Results: In 34 patients presenting with CP, the maneuver led to a statistically significant average reduction in pain of 1.32 points (18.5 %) (z = 3.124; p = 0.0009; alpha = 0.01; confidence interval = 1.047). 38.2 % (13/34) were classified as responders, experiencing an average NRS decrease of 3.7 points (64.0 %). The remaining 61.8 % (21/34) were non-responders. Subgroup analysis showed decrease in noncardiac CP was 1.5 points (21.3 %), while cardiac CP decreased 0.9 points (12.7 %). No major adverse outcomes were observed. Conclusion: This small study suggests the sternal brace provides modest effectiveness in pain reduction in ED patients with a chief complaint of CP.