Thoracic pain is an uncomfortable sensation that is found in the area surrounding the spine from the base of the neck to mid-back, just above where you can feel your lowest rib. Most people associate back pain with the lower area above the buttock or in the neck, but are less familiar with the upper trunk – yet research is finding that thoracic pain is almost equally as common as the aforementioned areas. It can come in several forms, with pain present on one side local to the joint; or pain that can radiate from the spine in a rib-like pattern; or dull, diffuse pain that tends to sit around your shoulder blades. Musculoskeletal pain of thoracic origin can be triggered by neck or shoulder range of motion, as thoracic mobility is required for tasks which require neck/shoulder motion. Since rib expansion is necessary to allow inflation of the lungs with breathing, thoracic spine pain can also occur during breathing. Unless the region is acutely injured or inflamed, thoracic pain should be affected by movement of the surrounding area (therefore, not remain static or constant).
A physical therapist is knowledgeable in assessing these movement patterns and finding possible “pain-generating” areas. Mid-back pain can originate from degenerative changes of joints; extra or limited mobility at vertebral (spine bone) or rib joints; disc injuries (tissue between spine bones); ligaments (tissue holding bones together) and muscles. This pain is commonly a result of a traumatic injury; heavy lifting; or improper posturing, but can also appear insidiously. Acutely, one can experience severe thoracic pain that can be very sharp, increasing with transitional movements, arm use, breathing, coughing/sneezing, or placing direct pressure on the area. Depending on the injury, numbness and tingling may also be associated with this pain.
Chronic back pain may only have some of these components and may be something that people “deal with” due to beliefs that “everyone has this pain” or “it’s not low back or neck pain, so it must not be something to worry about.” If you are experiencing pain, there may be a mechanical reason that can be addressed that can help lessen or alleviate your pain and lessen the daily stress associated with chronic pain. There may also be other, more serious underlying causes of thoracic pain, including pain referred/generated by underlying organs or other conditions that a physical therapist will assess and ensure that you receive the appropriate follow-up care.
The good news is that most people are appropriate for and respond well to conservative treatment – albeit acute or chronic thoracic pain. Thoracic physical therapy may include education on the condition; pain management training; postural and ergonomic training; manual therapy of joints (mobilization and/or manipulation); core stabilization training; and general strengthening and stretching. If you are experiencing symptoms similar to those previously described, make an appointment with your physical therapist. Your therapist can assist you in developing a personalized series of back exercises that can help you achieve goals related to daily activities or other interests/sports.