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Injury Treatment & Prevention in the Thoracic Spine

Thoracic pain is a problem we see more and more regularly here at Synergy Healthcare, most often it is caused by a sprain of the costo-vertebral joints where your ribs meet your spine and usually with associated strain through either the intercostal muscles or the deep paraspinal muscles that act upon the costo-transverse joints and thoracic vertebral joint.

It can cause localised pain as well as referral around your rib cage and into your chest – especially when you breath deeply or sit for long periods. These patients most often present with a slight initial pinch or grab sensation in the mid back following lifting or twisting activities and it can worsen as they cool down after exercise ceases. The classic at risk client normally presenting with this injury demonstrates increased kyphosis (thoracic curve), limitation to thoracic rotation and extension as well as possible anterior muscle dominance in their upper body.

Symptoms include a tight sensation and pain with breathing and twisting movements locally in the thoracic region and referred pain around the ribs and chest. There are a number of factors that can lead to this injury – including poor technique in lifting, poor posture and incorrect motor controls patterns in rotation.

The structures involved in these injuries are often a zygopophyseal (facet) or costovertebral (rib to spine) joint which has suffered a sprain or experienced movement beyond its normal range – resulting in local muscle spasm and guarding to prevent further movement at this joint.

There are a number of possible causes for problem in this region – including, trauma, poor posture, tightness in joints or muscles and poor control during movement. Appropriate treatment usually settles this problem fully within 2-3 weeks but you may need to modify your program to prevent it happening again.

Spinal manipulation has been found to be a very effective modality in the treatment of acute and sub acute thoracic spinal pain, with specific adjustments able to restore thoracic facet and costo-transverse joint movement as well as helping to manage and decrease localised muscle spasm.

Handy Tips

As part of your rehabilitation plan or even to prevent these injuries from happening again here are some handy tips that will keep you pain free:

  • Be posturally aware; When sitting, especially whilst at work keep your feet on the ground. gently roll your pelvis forward and pull your shoulder blades down and back. The muscles around your neck and in your back should feel relaxed and soft
  • Perform a regular stretching program – including upper back rotation and stretching up and over a chair when sitting
  • At home – roll up a towel, lie down on the floor on your back and place the towel horizontally underneath you. Gentle lean back and stretch, hold for 30 secs and then move it up your back and repeat. This exercise should be performed under the supervision of your therapist first before it becomes a home exercise, only to ensure the right areas are being targeted.

If you or anyone you know are currently suffering from thoracic (mid back) or rib pain seek some advice from your healthcare professional or better yet come in and see us here at Synergy Healthcare, where we can diagnose your specific injury and begin to formulate a treatment and rehabilitation program to get you pain free and back to 100% as soon as possible!


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