Thoracic Pain and Stiffness

What is Thoracic Pain?

Your thoracic spine is the region of your spine between your neck (cervical spine) and your lower back (lumbar spine). Your thoracic spine is unique in the fact that your ribs articulate with the vertebrae in the thoracic spine. Whilst this provides stability and protection for your vital organs and chest cavity, it comes at the expense of mobility.

Due to the increased stability and decreased mobility of the thoracic spine, the structures more likely to provoke pain include the joints and muscles in the area rather than the intervertebral discs. These structures are likely to be irritated over a prolonged period of time and will have a slower onset of pain. Generally this type of pain is by poor posture.

What is Poor Posture?

Rounded shoulders

This leads to increased flexion through the thoracic spine and results in increased load on the joints in this region
This results in tightness in your pectoral muscles, upper trapezius and levator scapulae muscles and leads to weakness of the muscles that hold your shoulder blades in the correct neutral position

Forward head
Chin poked with extension through the upper neck joints

Causes of Poor Posture:

Decreased strength and endurance of your neck and shoulder blade muscles
Increased stiffness of your neck joints
Poor desk (ergonomic) set up at work/home
Natural body structure

Symptoms of Thoracic Pain:

Symptoms of thoracic pain will vary from person to person but may generally include:

Generalised ache in your thoracic spine region
Ache that increases over the day (as you sit for longer and longer)
Stiffness in your thoracic spine
Stiffness in your neck
Associated neck ache (see our article on posture-related neck pain for more information)
Headaches (see our article on cervicogenic headaches for more information)
Jaw clenching (see our article on the TMJ for more information)
Arm pain (arising from irritation of the nerves in your neck)
Associated lower back ache

Assessment of Thoracic Pain:

Your All Care Physiotherapist will ask you a series of questions relating to the onset, cause, and behaviour of your thoracic pain. They will also ask you about your office and desk set up (e.g. type of desk, computer screen layout and chair height) as these factors often play a key role in your neck pain. They will then complete a comprehensive assessment of your thoracic spine, neck and even lower back, which can include:

Muscle bulk
Range of movement of your thoracic spine, neck and lower back
Degree of movement of the individual joints in your thoracic spine, neck and perhaps lower back
Neck muscle strength
Shoulder blade muscle strength
Arm strength and sensation
Movements of your jaw
Core muscle strength

Treatment for Thoracic Pain:

Luckily, physiotherapy is very effective for most episodes of thoracic pain. Your All Care Physiotherapist will provide you with an effective treatment plan that may include:

Advice and education on your condition
Postural education and retraining
Soft tissue releases
Dry needling
Joint mobilisations and manipulations
Heat therapy
Strengthening exercises for your shoulder blade and neck muscles
Range of movement exercises for your neck and thoracic spine
Postural taping

What Can You Do to Help?

1. Improving your Posture:

Good posture does not mean being as stiff as a board. The aim of good posture is to use stabilising muscles to take the weight of your body and minimise the stress on your other structures. Good posture consists of:

Growing tall through the crown of your head
Gently opening up through your chest
Relax the shoulders
Feet shoulder width distance apart with equal weight through both feet

Good posture is essential for optimal spinal health.

Remember to sit up tall as you are reading this!

2. Thoracic Self-Mobilisation with a Foam Roller:

Lie on your back, place both hands behind your head to provide support.
Place the roller on your thoracic spine (where it feels tight) and slowly arch your back over the roller for a stretch
You can roll the roller up and down your thoracic spine to self-mobilise the joints in this region.
You can also roll from side to side to mobilise the joints between your ribs and thoracic spine
Avoid rolling down into your lower back!

3. Basic neck stretches:

Stretches should move into gentle resistance of the muscle and be able to be maintained for 10 seconds.
For stretches to be beneficial, you need to perform then at least once a day.
Stretching should not cause you pain or discomfort – if it does, stop stretching and consult your physiotherapist.

4. Upper Thoracic retraction:

Placing both hands on either side of your neck, gently nod your chin and take the lower part of your neck slightly back.
Hold for 5s, repeat 5 times.
Do 4-5 times daily.

To get control of your thoracic pain, call All Care Physiotherapy today on 1300 291 133 and get back to the activities you enjoy!

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