Thoracic spine pain

Thoracic spine is the part of spine at the chest level. It connects the cervical spine (neck) and the lumbar spine (lower back). It consists of twelve vertebrae. Its main function is to support the body and also to connect with ribs to form the rib cage in order to protect the heart and lungs.

The whole spine is not completely straight. It consists a bit of curve. Both cervical and lumbar spines curve backward (concave backward). Thoracic spine is curving forward. If these curves are abnormal, either curve too much or too straight, it will change the stressing point on the cartilage (vertebral disc) and the joint of spine The abnormal stress can lead to problems such as arthritis and joint stiffness. Bulging vertebral disc can also be a problem. Eventually, the nerve next to the joint can be compressed or irritated. When this type of problem happens at the thoracic spine, it will cause thoracic spine pain. Sometimes, it can cause pain at the shoulder and even the front of chest. Indirectly, it will affect the mobility of shoulder joint.

Humped back caused by excessive curvature of the thoracic spine is a common problem. Excessive curvature can be due to posture, congenital, degenerative, nerve and muscle related, and diseases. Bad posture can increase the natural curve of the thoracic spine. This is quite common among teenagers, especially in females. Majority is caused by prolonged period in sitting position (such as due to work and study). Posture related curvature is easier to correct. The curvature can be improved when bad posture is corrected over a period of time. If bad posture has been maintained for a very long period of time, then modifying posture is more difficult. Then there is the need to loosen front chest muscles, to strengthen muscles between shoulder blades and also to promote thoracic spine joints flexibility.

The main cause of excessive bending (more than 40 degrees), other than posture, can be problems in the spine structure, such as vertebral disc (the cartilage between vertebrae) or ligaments. Usually congenital problems are more severe. Vertebral bone can be formed abnormally and lead to excessive bending of the spine. If the underlying problem is degenerative or disease types of problem, such as osteoporosis, it can cause the vertebrae to be compressed and deformed, and leads to excessive curvature. In order to differentiate the causes of excessive curvature, you can just simply lie on your back flat. If the curve disappears, then it indicates that the curve is due to posture. If the curve remains the same, it is usually caused by structural problems.

The treatment for excessive curvature of the thoracic spine caused by degeneration and disease is quite difficult, but preventable. For example, osteoporosis (over weight and menopause are high risk groups), with good diet habit and weight bearing exercises, in addition with appropriate hormone replacement therapy, it can decrease the chance of osteoporotic symptoms. Therefore, it can also prevent thoracic spine from bending too much or causing pain. Your physiotherapist can provide manual therapy to loosen up your thoracic spine joints which will help to decrease the amount of irritation on your back and therefore less pain. With exercises, there is the need to strengthen the muscle along both sides of the spine and abdominal muscles. The flexibility of the muscle behind the thigh (hamstrings) needs to be maintained. This prevents the pelvis being pulled by tight muscle which leads to uneven bending of the spine. Aerobic type of exercise is also essential. This is because when thoracic spine is in excessive bending or in pain, respiratory function can be affected. Breathing difficulty can occur. If the curvature is too excessively (more than 60 degrees), back correcting brace or surgery would be the last treatment options.

If you have any further questions, please contact your physiotherapist. Through detailed assessment, a personalized treatment and exercise program can be provided in order to minimize the excessive curve in thoracic spine and also the pain.