What causes thoracic spine pain and how to reduce symptoms?

Thoracic spine pain or mid back pain can be largely disabling and result in high pain levels. Although it is not as common as low back or neck pain, it is still a common occurrence, especially in people who are mostly sedentary through the day.

Postural mid back pain

Mid back pain which develops from poor posture or inactivity is common among the office working population. Most cases will not have a specific mechanism of injury, but more a gradual onset, occurring around the time where more sedentary tasks have been completed. Generally this pain will worsen as the day progresses, particularly if a large part of the day has been spent in sitting. Ways to counteract this pain from developing include;

• Using a sit stand table (if available) to move into standing for 15 minutes for every hour
• Maintaining contact with the backrest of the chair when sitting
• Completing regular stretching and foam rolling exercises
• Having an ergonomic assessment

Along with the above strategies, manual therapy via a physiotherapist, chiropractor or massage therapist can also be of aid to reduce symptoms. With postural back pain however, addressing the cause of symptoms is critical to making a full recovery. This is where exercise based strategies are important to help improve the endurance of postural muscles in the mid back, along with improving mobility to prevent the development of stiffness and pain. Exercise such as Pilates focuses on muscle control and strength and joint flexibility which all aid in managing this condition.

Joint sprains/muscle spasms

Joint sprains and muscle spasms in the mid back will result due to a quick, awkward movement or when lifting an object in a difficult position or with poor posture. There will always be a specific mechanism that results in pain, with the nature of pain being sharp and intense. These injuries can be highly disabling, with high pain levels for 2-3 days following the injury, along with a large restriction of movement (usually rotation movements), difficulty breathing and sometimes chest pains. Manual therapy from either a physiotherapist or chiropractor will help to settle muscle spasm, increase movement and decrease pain. Management strategies also include;

• Heat packs/heat creams
• Gentle stretching and movement
• Pain killers and/or anti-inflammatory medications
• Avoiding lifting and bending tasks (in the short term)

Joint sprains and muscle spasms in the mid back have a very positive prognosis, with the majority of cases returning to normal within 1-3 weeks.