The upper back or the thoracic spine joins the cervical spine (neck) and the lumbar spine (lower back) together. The upper back is made up of 12 vertebrae, and is built for stability. This stability plays an important role in holding the body upright and providing protection for the vital organs in the chest.
The rib cage is connected to each level of the thoracic spine, ribs connecting from T1-T10 curve around to meet at the front of the body and attach to the chest wall, or sternum. The ribs connected to T11 and T12 do not attach to the sternum in front. Because these levels have slightly less stability they are more prone to problems that can cause pain.
The thoracic spine has thinner intervertebral discs, this adds to the upper backs relative inflexibility, however it is less common to have disc problems in this region for the same reason. The thoracic spine also has a narrower spinal canal, which is where the spinal cord runs through. An injury to a vertebrae in the thoracic spine puts the spinal cord at risk of damage
Pain in the Thoracic spine can be caused by:
- Muscle Tension- Tightness or tension through the paraspinal muscles running along the side of the thoracic spine are a common source of pain. They can lead to tenderness on palpation, pain with movement and decreased joint mobility if left un-treated.
- Joint Stiffness/ Injury – The facet joints along the thoracic spine also articulate with the ribs making it a complex base of support. Stiffness or joint injury can cause central, bilateral (both) or unilateral (one-sided) thoracic spine pain or discomfort. If left un-treated can also lead to problems with ribs function and breathing.
- Arthritis- Swelling due to arthritis in the spine can cause tenderness, can put pressure on exiting nerve roots and limit range of motion. Arthritis is often due to wear and tear and part of the aging process. However keeping mobile, and reducing secondary pain from joint stiffness and muscle tension can limit the effect that arthritis has on your thoracic spine.
- Herniated or degenerative discs- While less common in the thoracic spine, degenerative disc disease or herniated discs can also be a source of pain in the thoracic spine.
- Vertebral fractures- these can be sports related, commonly seen in gymnasts, cricket players and football players, or compression fractures which are more often seen in the older population and those with osteoporosis. Most commonly seen at T9-T12.
- Kyphosis- This can be anatomical in nature or due to poor postures, or a combination of both. Reducing excessive kyphosis will limit pain in the thoracic spine, this can be achieved with strapping and proper exercises.
- Scoliosis- AS above, can be born with or develop through bad postures. Education regarding correcting your postures, combined with an effective stretching and strength program can assist in the treatment of scoliosis.
Thoracic pain can be due to numerous underlying factors, if you are having pain in your upper back or experience any of the symptoms above make an appointment to see our expert Physiotherapists who will assess and guide you in your recovery.