Thoracic back pain is a common musculoskeletal complaint treated by chiropractors, physical therapists and medical doctors. According to the Spine-health website, thoracic or upper back pain may occur from trauma or sudden injury, muscle strains or poor posture. Many people who work at computers on a daily basis report upper back pain, along with neck and shoulder pain. Common causes of thoracic back pain include spinal joint dysfunction, rib subluxation, and muscle irritation and tightness.
Spinal Joint Dysfunction
Spinal joint dysfunction is a common cause of thoracic back pain. According to a study by J. Y. Menck and colleagues published in the "Journal of Orthopaedic & Sports Physical Therapy," thoracic spinal joint dysfunction can contribute to reduced shoulder range of motion and pain or discomfort throughout the upper back and extremities. The researchers note that thoracic joint dysfunction--aberrant movement of the thoracic vertebrae's facet joints, also known as joint fixations--can be helped by vertebral manipulation, which involves a high velocity, low amplitude thrust to the upper thoracic vertebrae. PhysioAdvisor.com states that thoracic spinal joint dysfunction may be caused by facet joint sprains, which involve tearing of the connective tissue surrounding the facet joints. Facet joint sprains often occur during excessive bending, lifting or twisting movements, and they may occur with trauma or poor posture.
Muscle Irritation and Tightness
Muscle irritation and tightness can cause thoracic back pain. Several large muscles attach to the scapulae, or shoulder blades in the upper back, along with the back of the thoracic rib cage. Because of the forces exerted on them, and because of the tendency for many people to have poor posture, the bulky upper back muscles may develop irritation or myofascial pain and become tight and tender. Tight upper back muscles can be difficult to stretch and relax, and they often require treatment by a manual medicine practitioner to resolve any pain or dysfunction. According to the Spine-health website, muscle-related upper back pain may be caused by such factors as muscular de-conditioning, repetitive-use injuries, muscle strains, sports injuries, motor vehicle accidents and others. Areas of focal pain in the upper back may be caused by trigger points--hyperirritable nodules within a tight band of muscle. Trigger points in the rhomboid muscles, situated between the shoulder blades and the spine, are particularly common.
Rib Subluxation
A rib or costovertebral subluxation can cause significant pain in the upper back. The Spine-health website states that the ribs connect with the thoracic vertebrae in two locations and that dysfunction, including subluxation, in these joints can cause upper back pain. According to the Kansas Chiropractic Foundation, a subluxation involves a displacement of the spine or ribs that causes interference to the nervous system. Dr. David Seaman, a chiropractic physician with Dynamic Chiropractic, notes that a subluxation, including rib subluxations, involve reduced mechanoreceptor--a sensory receptor that reacts to mechanical pressure or distortion--input and increased nociceptor--a sensory receptor that reacts to painful or damaging stimuli--input. Alterations in these sensory receptors may influence several centers in the central nervous system and cause numerous neurological symptoms, including pain. Restoring normal joint function using manual medicine techniques, such as joint manipulation, may normalize the aberrant sensations affecting the joint's sensory receptors.
References
- Spine-health: Causes of Upper Back Pain
- "Journal of Orthopaedic & Sports Physical Therapy"; Thoracic Spine Dysfunction in Upper Extremity Complex Regional Pain Syndrome Type I; J. Y. Menck et al.; July 2000
- PhysioAdvisor.com: Facet Joint Sprain
- Kansas Chiropractic Foundation: Glossary of Chiropractic Terms
- Dynamic Chiropractic: David Seaman, D.C., M.S., DABCN
