Thoracic Spine (Mid Back) Pain
The thoracic spine is the area bounded by the rib cage, between the neck and the low back. This area is a key area of load transfer as the ribs act like springs to maintain our upright posture. This area is extraordinarily complex, has multiple joints and relies on muscles which impact the neck, low back, and shoulder blades.
Osteoarthritis and DISH
Osteoarthritis is when the joint cartilage degenerates. The inflammation from the process can be painful and often leads to the joint and surrounding structures stiffening up. Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a hardening of your ligaments surrounding the joints, leading to stiffness.
Physiotherapy works to reduce stiffness in the thoracic spine with hands on Physiotherapy, heat and prescription of movement and strengthening exercises.
Postural Related Pain
Postural pain often has no injury, rather a buildup tension or pain over time. There is no "bad" posture, however maintaining a position for a long period of time can stress the structures in and around your spine. Physiotherapy aims to determine what postures are stressing the middle back and will work with you to provide relief from pain and tension and to modify aggravating activities.
Scheuermann's disease
Scheuermann's disease predominantly effects children between the ages of 10 and 15 during their growth spurt, with more males affected than females. During the growth spurt, bony stress leads to an abnormal growth of the spine, with accelerated bone growth at the back of the vertebra compared to the front. This results in wedging of the vertebra, and a rounding of the middle back.
Usually this disease only causes mild symptoms, generally associated with growth pains through the middle of the back or stiffness. This can even be found incidentally in older age through x-rays of surrounding areas without having any previous symptoms. Majority of the time Scheuermann’s disease is mild and can be effectively managed with physiotherapy, with a very rare case requiring further intervention. Physiotherapy aims to reduce pain levels through heat and movement, education and exercise. Your physiotherapist will develop a home program to ensure you do not lose range of motion, or strength during this painful time. This will help to reduce the stress on the bones in the back and surrounding areas.
Scoliosis
This condition arises in childhood, generally during the child’s growth spurt and effects more females than males. Scoliosis involves a sideways and rotational curvature of the spine. Depending on the severity, scoliosis can cause pain, stiffness and dysfunction.
Physiotherapy aims to do an in-depth assessment, including referral for imaging to assess and monitor your Cobb Angle (the degree of the curve) over time. If scoliosis is deemed mild, physiotherapy will work with you to improve your strength and posture through a series of exercise progressions. These aim to assist in gaining control of the deformity through muscular strength, as well as increase your tolerance to gravity. If you have a larger degree of scoliosis you may need to see a specialist regarding bracing or, in rare cases, surgical correction.
Costochondritis / Tietze Syndrome (front of chest pain)
Both these conditions are characterized by a swelling and inflammation at the front of the ribs where the costal cartilage from the ribs attaches to the sternum. Tietze syndrome commonly affects the 3rd/4th/5th ribs, with reddening and swelling, and morning stiffness. Costochondritis can be an acute or chronic injury to the cartilage from infections, acute trauma or chronic stress. Costochondritis and Tietze syndrome both affect your ability to move the thoracic spine, as well as pain with deep breathing or coughing.
Physiotherapy, in conjunction with your doctor (anti-inflammatory medication) will assist to reduce inflammation, decrease stress due to joint stiffness and muscular tightness. Further we can develop strategies to ease pain during functional activities and sleeping.
Contact Free Movement Physio to book an appointment for a one on one consultation to discuss your Thoracic spine concerns.