Thoracic Spine Pain

What is the thoracic spine?

The thoracic spine is the longest portion of the spinal column and is also known as the mid/upper back. It consists of twelve vertebrae and sits directly behind the chest, between the shoulder blades. Each thoracic vertebrae connects to a rib on either side. The ribs then curve around to connect to the sternum at the front, forming the ribcage. Due to these rib attachments, the thoracic spine moves less than the lumbar & cervical spines (low back & neck). This makes it more stable & less susceptible to injury or wear & tear. When injury does occur however, thoracic spine pain can cause significant discomfort & should be treated early to prevent worsening or recurrence.

How do I injure my thoracic spine?

Usually thoracic spine pain is caused by minor problems in the joints, ligaments or muscles. Disc & nerve injuries can occur in the thoracic spine, but they aren’t as common as other areas of the spine.

Pain can sometimes be caused by a sudden movement or injury (eg. a sudden awkward twist or a fall). However, often, the pain starts gradually or for no obvious reason at all. It may be caused by sleeping badly overnight, spending too much time on the computer, or being on a long plane/car trip.

What are the symptoms?

The symptoms will depend on which structure is injured. Generally, the thoracic spine can give you pain in 3 main areas. These include; under or between your shoulder blades, into your shoulder or arm and even into your chest or abdomen. It can be a deep ache, a sharp, localised pain, or a sharp pain down the arm with pins & needles/numbness associated. As a result of the rib attachments to the thoracic spine, it is not unusual to experience pain with a deep breath in.

What can I do to prevent thoracic spine pain?

There are a number of things you can to do help maintain a happy thoracic spine. First & foremost is making sure you sit & stand with good posture. In sitting try to maintain the curve in your low back. This can be done using a lumbar roll or a rolled up towel placed in the small of your back, draw your shoulders down & in gently, & tuck your chin in. It is also important to use a good quality mattress & pillow to sleep on, & to avoid sleeping, standing & moving in awkward ways.

If you suspect that your thoracic spine is giving you pain, make sure you have it assessed & treated quickly. Often this area of the spine responds well to physiotherapy treatment, & your physio can also help determine what factors may have contributed to the problem to prevent it from happening again.