THORACIC SPINE PAIN
Unfortunately, as our reliance on technology increases, so does the incidence of thoracic spine pain and pain referred from the thoracic spine.
The basic issue is postural overload. More specifically, compression through the spine in prolonged flexion postures, lack of lower rib excursion in breathing and strength loss as a result of sedentary lifestyles.
Fortunately, most cases of thoracic pain will respond to manual intervention and strengthening, but it is important to be aware of the causative postures and try to avoid them. The thoracic spine is not as mobile as the neck or lower back, but is still designed to flex, extend, rotate and laterally flex. Unfortunately, much of our working life is spent in flexion and then slumping in exhaustion on the couch at the end of the day.Simple measures to help improve thoracic function include regular stretch breaks, incorporating extension, rotation and lateral flexion movements. Also- consider upper back strengthening to hold the spine more upright. This can often be done with an exercise band and a door handle, so it’s not too onerous.If pain persists, careful clinical examination is required to try to identify the source of the pain. The thoracic area is complex. There are facet joints, costovertebral joints, costotransverse joints, discs and numerous ligaments on both sides of each vertebra. Sometimes it can be difficult to say where the pain is starting. This is one occasion where bone scanning with SPECT CT can be helpful to identify the inflamed joint, but, be warned, scans are often negative.
If sensitisation is suspected, a trial of amitryptiline may help reduce pain. Occasionally injections are required. Rehabilitation of mobility and strength are ALWAYS imperative.If you would like to chat to one of our Doctors regarding this, please call (03) 9770 2398 to book an appointment.
