Steps for Treatment:

1. Patient prone, Physician standing at patient side
2. Physician hand placement –
   • Caudad Hand: thumb and thenar eminence on medial aspect of pt’s thoracic paravertebral musculature overlying transverse process on side opposite of the doctor; fingers point cephalad
   • Cephalad Hand: hypothenar eminence on medial aspect of pt’s paravertebral musculature overlying transverse process on ipsilateral side of doctor, fingers pointed caudal
   • Make sure your wrists are at the same level, so the tissues push past each other. 
3. Gentle force with both hands, ventrally to engage soft tissue and then in direction fingers are pointing
4. Repeat in gentle, rhythmic/kneading fashion; lift and reposition hands to contact different levels of the thoracic spine 
5. Work up and down the thoracic spine, lifting and repositioning to contact different levels

Video Tutorial: