Logan Steele
Thoracic back pain is a common issue, affecting 15–35% of the general adult population annually. The thoracic spine is located in the middle and upper back, between the neck and the lower back. While thoracic back pain is usually temporary and treatable with simple painkillers and gentle exercise, it can sometimes indicate a more serious underlying issue. Thoracic back pain can be caused by muscle strain, ligament sprains, or muscle irritation due to poor posture and prolonged sitting. However, it can also be caused by more serious problems, such as herniated discs, spinal tumours, or even cancer. Therefore, it is important to seek medical advice if the pain persists or is severe.
| Characteristics | Values |
|---|---|
| Location | Middle or upper back |
| Causes | Muscle strain, inflammation, ligament sprains, compression fractures, herniated discs, spinal stenosis, spinal tumours, osteoporosis, trauma |
| Risk factors | Poor posture, prolonged sitting, heavy backpacks, violent trauma (e.g., vehicle accident or fall), strenuous lifting, age under 20 or over 50 |
| Treatment | Simple painkillers (e.g., ibuprofen, paracetamol), gentle exercise, physical therapy, injections, rest, surgery (laminectomy) |
| Prevention | Regular exercise (e.g., walking, swimming), warm-up and cool-down exercises, ergonomic workstations, correct weight-lifting techniques |
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What You'll Learn
Poor posture and prolonged sitting
Sitting for long periods of time can be a major cause of lower back pain. This is because sitting for extended periods can add a tremendous amount of pressure to the back muscles and spinal discs. Sitting in a slouched position can overstretch the spinal ligaments and strain the spinal discs, damaging spinal structures and contributing to recurrent episodes of neck or back pain.
Poor posture can also be a contributing factor to lower back pain. Slouching forward or leaning too far back can create problems, even if the back pain is not caused by poor posture. Weak core muscles may not be supporting the spine well enough, leading to pain.
A study comparing the fatigue of trunk muscles in an upright, slumped, and forward-leaning posture for one hour in office workers reported muscle fatigue only in the slumped sitting posture. Another study measuring the fatigue of trunk muscles in healthy subjects when using a laptop with unsupported sitting and slumped posture for 40 minutes showed fatigue of trunk muscles such as the MF, IO, erector spinae, and external obliques. This suggested that these muscles were continuously activated to stabilize the trunk as postural control muscles while performing tasks.
To reduce lower back pain, it is recommended to stand, stretch, and walk at least a minute or two every half hour. Adjusting your computer screen to eye level can also help, as tilting your neck back to read the screen can strain your neck and shoulders.
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Trauma and accidents
One of the most common causes of thoracic back pain is inflammation, which can be caused by a sudden sprain or strain from trauma or accidents, such as car accidents or falls from a height. Ligament sprains can occur when a sudden twisting motion causes the ligaments in the thoracic region to overstretch beyond their limit, resulting in pain. Trauma, such as a direct blow to the thoracic region, can also lead to muscle irritation or tension, causing tightened muscles and pain.
In addition to trauma and accidents, thoracic back pain can be caused by overuse injuries, which are common in individuals who repeatedly lift, bend, or twist their thoracic spine. These repetitive motions cause micro-injuries that contribute to spinal pain. Poor posture and prolonged sitting can also lead to thoracic back pain by causing muscle irritation and tightened muscles.
It is important to note that thoracic spine pain often has a musculoskeletal origin and is more likely to be caused by a serious underlying pathology than neck or low back pain. Therefore, if you experience persistent pain or severe symptoms, it is recommended to seek medical advice to diagnose and treat the underlying cause.
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Overuse injuries
Thoracic back pain is a common issue, affecting 15% to 35% of the general adult population each year. The thoracic spine is located at the back of the chest, between the shoulder blades, and extends from the bottom of the neck to the start of the lumbar spine (roughly at the level of the waist). Thoracic spine pain is usually not serious and often resolves on its own. However, it is more likely than neck or lower back pain to have a serious underlying cause.
One potential cause of thoracic back pain is overuse injuries. These injuries are commonly caused by repetitive motions involving the thoracic spine, such as repetitive lifting, bending, and twisting. Overuse injuries can lead to micro-injuries that cause spinal pain. The pain from overuse injuries is typically aching and deep and may persist at night, disrupting sleep.
To prevent and treat overuse injuries, it is important to address the underlying cause. This may involve modifying activities or occupations that involve repetitive motions. Exercise, such as walking or swimming, can help to strengthen the muscles and reduce the risk of overuse injuries. It is crucial to perform warm-up and cool-down exercises before and after more vigorous activities. Maintaining good posture and ergonomics, especially when sitting for long periods, can also help prevent overuse injuries.
If the pain from an overuse injury persists or is severe, it is important to seek medical advice. A healthcare provider can assess the underlying cause and recommend appropriate treatments, which may include medication, physical therapy, or multidisciplinary rehabilitation. Early treatment is crucial for effective management of thoracic spine pain.
In summary, thoracic back pain can be caused by overuse injuries resulting from repetitive motions. Prevention and treatment involve addressing the underlying causes through activity modification, exercise, and posture improvement. Seeking medical advice is important for persistent or severe pain, as early treatment can improve outcomes.
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Muscle strain and ligament sprains
Thoracic back pain is a common issue, affecting 15-35% of the adult population annually. The thoracic spine is located at the back of the chest, between the shoulder blades, and extends from the bottom of the neck to the start of the lumbar spine. While the thoracic spine is less prone to injury than the lumbar spine, muscle strain and ligament sprains can cause thoracic back pain.
A muscle strain involves the twisting, pulling, or tearing of muscles and tendons that support the spine. This can be caused by a single instance of improper lifting or by overstressing the back muscles. A sprain, on the other hand, is the stretching or tearing of a ligament, which can occur when a joint is forced out of its normal position. Ligament sprains can result from a sudden twisting motion in the thoracic spine, causing the ligaments to overstretch. Both strains and sprains can be acute, with sudden onset, or chronic, resulting from repetitive strain or overuse.
To treat muscle strain and ligament sprains in the thoracic region, initial management includes rest, ice packs, and compression during the first 24 to 48 hours. Nonsteroidal anti-inflammatory drugs, such as ibuprofen, can help reduce pain and swelling. It is important to avoid extended bed rest as it can prolong symptoms and delay recovery. After the initial phase, a gradual return to normal activities is recommended. Physical therapy may be beneficial, including exercises such as pelvic traction, massage, ultrasound, electrical muscle stimulation, and stretching.
To prevent thoracic back pain due to muscle strain and ligament sprains, regular exercise is key. Walking, swimming, and gentle exercises can help strengthen the spine and improve stability. Maintaining good posture and avoiding prolonged sitting are also important. Additionally, it is crucial to perform warm-up and cool-down routines before and after vigorous activities to reduce the risk of injury.
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Herniated discs
While herniated discs can occur anywhere along the spine, they most commonly affect the lower back (lumbar spine) and neck (cervical spine). It is rare for a herniated disc to occur in the upper-to-mid back (thoracic spine) due to its rigid and stable structure. However, when a herniated disc does occur in the thoracic spine, it can lead to unique symptoms.
In the thoracic spine, a herniated disc may compress a spinal nerve, resulting in pain and numbness travelling around the rib cage from the back to the front of the chest or upper abdomen. Additionally, a large herniated disc in this area may compress the spinal cord within the spinal canal, causing numbness, stiffness, and weakness in the legs, and possibly impacting bowel and bladder control.
The diagnosis of a herniated disc in the thoracic spine typically involves a complete history of the problem, a physical examination, and imaging techniques such as X-rays, MRI scans, myelograms, and CAT scans. Treatment options may include conservative approaches such as pain management and physical therapy, or more invasive procedures such as surgery (laminotomy and discectomy) or microdiscectomy, which involves removing the portion of the disc pressing against the nerve using microsurgical tools.
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Frequently asked questions
Thoracic back pain is pain that occurs in the thoracic spine, which is located at the back of the chest, between the shoulder blades, and extends from the bottom of the neck to the start of the lumbar spine.
Thoracic back pain is often caused by muscle strain or irritation due to poor posture and prolonged sitting. It can also be caused by sprains, compression fractures, herniated discs, spinal stenosis, spinal tumours, and traumatic injuries.
Thoracic back pain can be treated with simple painkillers, anti-inflammatory medications, and gentle exercises like walking. Physical therapy and injections may also be recommended.
Thoracic back pain is typically felt in the middle or upper back, but it can sometimes radiate to other areas, including the lower back. While thoracic spine issues are less common than lumbar spine problems, the interconnected muscles, nerves, and ligaments in the back mean that thoracic muscle strain or irritation can potentially contribute to lower back pain.
