By Sydney CBD Osteopath Dr Abbey Davidson
What is the Thoracic Spine?
The thoracic spine, or mid-back, is made up of 12 bones known as vertebrae, along with 12 pairs of ribs, with its role being to protect the heart, lungs, and other important organs. Compared to other regions of the spine and body, there is less motion available through the thoracic spine so as to protect these structures.
Thoracic pain, although less common than lower back or neck complaints, is still commonly seen by manual therapists and is commonly linked with poor posture, desk jobs or congenital issues. Those particularly at risk are those greater than 40 years of age, who participate in minimal physical activity or have a history of trauma or heavy physical work.
What are the Common Causes of Thoracic Spine Pain?
Some of the most common conditions to cause pain in the Thoracic Spine include:
- Compression Fracture
- Postural Syndrome
- Scheuermann’s Disease
- Buffalo Hump
- T4 Syndrome
- Shingles/Herpes Zoster
What are the common structures which contribute to Thoracic 
Pain?
Pain?- Bones (vertebrae/ribs)
- Joints
- Muscles
- Ligaments
- Tendons
- Discs
- Nerves
What you can do to help yourself with Thoracic Spine Pain?
Where you have had an acute injury to the Thoracic Spine, you should apply ice for the first 24-48 hours. This attempts to reduce swelling/inflammation in the region and provide some pain relief. 20 minutes of application every hour should be sufficient. Try to avoid direct contact of the ice with your skin by placing a towel between. After 48 hours a heat pack can be applied to encourage blood flow, promote repair, decrease stiffness and muscles tension in the region.
Poor desk posture can be a major causative factor in thoracic pain. It can cause repetitive strain on the mid-back and other structures in the region, and this constant aggravation of the area can be responsible for a slower recovery. If you believe your desk posture is contributing to your pain, there are stretches and lifestyle advice which can help improve your posture, and you can also ask for a workplace ergonomic assessment. Your health professional should be able to prove you with this information.
Regular exercise and gentle range of motion exercises may provide positive results as it can promote thoracic range of motion and decrease stiffness in the region, as can strapping of the region. It is also important to avoid aggravating activities (like heavy lifting) while local tissues attempt to repair themselves.
Bed rest is generally not recommended in cases of thoracic pain.
When to should I seek professional help for Thoracic Pain?
You should consider booking an appointment with a health professional, such as a chiropractor, osteopath or physiotherapist, if you are experiencing any of the following symptoms:
- Severe pain (especially after acute trauma or injury)
- Unable to perform normal daily activities
- Pain which is not improving
- Nerve pain, pins, needles, tingles or weakness in arms/hands
- If pain is aggravated by breathing
What a health practitioner will do to help with Thoracic Pain?
Your health practitioner will spend time asking you questions and gathering a history of your pain. This will be followed by an assessment of the thoracic spine and surrounding spinal regions for range of motion, muscle tightness and pain. Your health professional will also perform a series of provocative testing, which will aid in establishing which structures are responsible for your pain, and whether it is indeed your Thoracic Spine that is the issue.
Your health practitioner will then apply techniques in an attempt to correct your spinal range of motion, and any muscle tightness, stiffness or poor posture you are experiencing.
Following your treatment, your health practitioner will reassess your spine to see if there have been any improvements or changes and, if seen fit, prescription of stretches and exercises will also take place to continue your progress into the future.
