Spinal physio care of the painful upper back
Our upper back has a lot of joints and muscles that makes it, and that makes it much higher risk of having injuries, pains and conditions. Even if just one muscle or joint injury from accident or working out can cause pain and discomfort with simple movements.
What spinal physios will do is to assess the dysfunction in the upper back and then treat your back pain.
Contents
Physio treatment and upper back pain
Our spines are long, so it’s divided into different segments. The 12 of 24 spinal bones at the mid and upper back is called the thoracic spine. This thoracic part has ribs which serves to protect vital soft tissues such as
- heart
- lungs
- stomach organs
- etc
To compare, your neck has only 7 vertebraes and your lower back has only 5
12 vertebrae = 12x more chances of injury and pain
Upper back pain is a very common problem that affects all age groups.
It’s not as well known than the common neck pain and low back pain, which as waaaaaaay more research and studies done on them. Conversely, mid and upper backs tend to be less popular, leading to less research done on them.
But that’s not quite fair, because as shared earlier:
- neck (cervical) has 7 vertebrae
- low back (lumbar) has 5 vertabrae
This leads to more risk of problems in thoracic (mid) back, which has 12 vertabraes (which makes half of the entire spine!).
Physio treatment for myofascial pain syndrome
So the thoracic spine (mid and upper back) not only has multiple vertebrae and joints, but there is also a number of layers of soft tissue that supports the structure there too, such as
- muscles
- ligaments
- fascia
They work to stabilize the mid and upper back as well as help the thoracic cage for breathing as well as moving your shoulders and arms too. Fascia is connective tissue that supports the spine and musculoskeletal system, and it surrounds the muscles, allowing muscles to glide smoothly.
Whenever there is any forms of injuries, overuse strains or prolonged poor posture, what happens is that you may develop myofascial trigger points or adhesions, and these are normally referred as myofascial pain syndrome. In fact, patients may get frustrated as these myofascial problems do not show up in any imaging work such as x-rays or MRI.
Good news is that physiotherapists can treat these invisible myofascial pain syndromes, typically these types of problems respond very well with manual therapy such as
- deep trigger point release
- deep stretch
- cold-and-stretch
- oscillating manual therapy
which can help to release the painful trigger points and adhesions.
Some adjunct therapeutic modalities such as ultrasound therapy and heat therapy may provide some level of comfort too, but man, nothing beats manual therapy and knowing exactly what structure to treat, and how much / little force.
Physio treatment for thoracic disc herniation
So it is pretty rare that disc herniations happening in the thoracic joints and the reason for this is because thoracic spines are typically pretty rigid (most spinal disc herniations tend to happen at joints that are more mobile; it’s the movements that increases the risk of herniations)…
…but these thoracic disc herniations do happen from time to time. And they hurt pretty bad.
Good thing is that most spinal problems and pains, including thoracic disc herniation, can be treated with non-invasive spinal physiotherapy without the need for surgery. And this is important because surgical access for thoracic disc is complicated due to the ribs, and the surgeon may have to consider removing a rib to access the thoracic vertebrae.
Of course, that can lead to other health issues down the road, so usually non-invasive physiotherapy will be the first option.
Physio treatment options
The goals of the physio treatment of a thoracic disc herniation are to generally three:
- reduce immediate pain (pain relief) and
- more importantly, treat the core problem and dysfunctions for full recovery
- prevent recurrence of problem
Most physios will work with you to reduce the discomfort and pressure caused by your disc herniation using a combination of these treatments:
- heat or cold therapy
- ultrasound therapy to accelerate soft tissue healing
- manual therapy
- exercise therapy
- electrical stimulation
- etc
Additional physio treatments for other types of upper back problems
Thoracic Joint Dysfunction
You know, our thoracic spine is prety cool – it
- contains 220 separate joints
- makes for the majority of the joints in the entire length of the spine (220 of 313)
With so many moving parts and articulations, maintaining normal functioning is very, very important. Some of the physio treatments we do to treat a dysfunctional thoracic joint:
- Manual therapy (including manipulation/adjustments where necessary) to mobilize the joint and normalize joint functions and movement
- Exercise therapy to support the joints (too weak can cause over-compensatory movement which lead to other issues down the road)
- Pain relief
Thoracic Outlet Syndrome (TOS)
Thoracic outlet syndrome (TOS) is a very specific type of disorder where the nerves of the brachial plexus and blood vessels are compressed. This can cause a mix of problems such as a combination or all of:
- altered sensations: numbness, pins and needles, tingling, burning sensation, cold
- weakness of muscles which nerves are affected
The thoracic outlet syndrome can be treated by a combination of
- release / decompression therapy works
- deep tissue release
- manual therapy
- heat therapy
- mobilizations and adjustments
- postural corrections
- etc
Thoracic/Shoulder Dysfunction
As a general rule of body –
everything is connected and interrelated.
Sometimes just a footwear issue can cause knee problems and leads to low back pain and even headaches due to the chain of effect problem. That’s why, an indepth deep-dive assessment to determine all the issues that cause and aggravate the problem needs to be assessed and prioritized to be treated.
You know, our thoracic spine is prety cool – it
- contains 220 separate joints
- makes for the majority of the joints in the entire length of the spine (220 of 313)
With so many moving parts and articulations, maintaining normal functioning is very, very important. Some of the physio treatments we do to treat a dysfunctional thoracic joint:
- Manual therapy (including manipulation/adjustments where necessary) to mobilize the joint and normalize joint functions and movement
- Exercise therapy to support the joints (too weak can cause over-compensatory movement which lead to other issues down the road)
- Pain relief
Thoracic Outlet Syndrome (TOS)
Thoracic outlet syndrome (TOS) is a very specific type of disorder where the nerves of the brachial plexus and blood vessels are compressed. This can cause a mix of problems such as a combination or all of:
- altered sensations: numbness, pins and needles, tingling, burning sensation, cold
- weakness of muscles which nerves are affected
The thoracic outlet syndrome can be treated by a combination of
- release / decompression therapy works
- deep tissue release
- manual therapy
- heat therapy
- mobilizations and adjustments
- postural corrections
- etc
Thoracic/Shoulder Dysfunction
As a general rule of body –
everything is connected and interrelated.
Sometimes just a footwear issue can cause knee problems and leads to low back pain and even headaches due to the chain of effect problem. That’s why, an indepth deep-dive assessment to determine all the issues that cause and aggravate the problem needs to be assessed and prioritized to be treated.
Where To Next?
- Go to Home / Start
- Learn and find out more about your pains (bones, muscles, joints, tendons, ligaments, nerves etc) at Pain Conditions & Injuries
- Visit our shop to see products we recommend for pain relief, heating, treatments and more
- Contact us
