Chiropractic From Head to Toe: Upper Back Pain

Although injuries to the upper back (thoracic spine) are not as common as lower back or neck injuries, there are still a number of conditions and factors that can contribute to pain and discomfort
in this area. Thankfully, your chiropractor knows how to ease your pain!
The thoracic spine is that area of your back where the ribs are attached—also called your upper back. Because of its location, the upper back and ribcage are designed to be more stable, creating a protective “cage” for many of your vital organs—like the heart, lungs, liver, stomach and spleen. Since the thoracic vertebrae do not have the same range of motion as the cervical or lumbar vertebrae, it is rare for someone to experience a disc herniation in this area.1 In fact, only about 1-3% of all disc herniations occur in the thoracic spine. Even when present, thoracic disc herniations do not necessarily cause symptoms in the person who has them! So, what causes upper
back pain?
Most of the pain felt in this region is caused by muscle and/or facet joint irritation. Many very important postural muscles are found in the upper back and will attach to the vertebrae in this area. Notably are the muscles that control shoulder stability—like the rhomboids and trapezius muscles. In addition, the postural muscles that support the head and neck in a vertical position will find their anchor points in the thoracic spine. These muscles are
collectively known as the erector spinae.
Whenever a person’s posture deviates away from the center of gravity, such as when the head is held forward or the shoulders rounded (two of the most common postural faults), this will put a large compressive load on the joints
between each vertebra (the facet joints), leaving them prone to feeling the stress and strain. Also, any minor spinal misalignments (subluxations) begin to feel like major ones when
there is any abnormal muscle tension in the area! Pain sensitive structures like joint capsules, ligaments and neighboring nerves can all be irritated by this phenomenon.

In addition, where each rib attaches to  the spine, there is a set of 3 joints  collectively called the costovertebral  joints. Since these are functionally  movable joints like any other in the  body, this means they are also subject  to the same stress and strain that other  joints experience and they can also  subluxate when put under an abnormally  high or sudden load. You’ve  heard the expression, “I have a rib  out”? This can be a very painful  condition where you feel a sharp,  stabbing pain on either side of the  spine. It may be difficult or painful to  take a deep breath, and laying on your  back with pressure directly on this area  may also be painful.
No matter whether the joint that is  irritated belongs to the vertebra or the  rib, your chiropractor knows exactly  what to do to set things right. You  guessed it—the chiropractic adjustment!
With the application of this  skilled and precise maneuver, the  irritated joint can be re-aligned to sit  properly, taking the pressure off the  sensitive structures that surround the  joint (capsule, ligament or nerve).
Regardless of which joint it is, once  freed from restriction and misalignment,  the physiological cascade called  “healing” can begin: sometimes the  relief from pain is immediate and  dramatic; other times it takes a few  days for the positive effects of the  adjustment to kick in. However, rest  assured the adjustment always initiates  healing.  When the vertebral subluxation is  reduced, muscle tension around the  joint will also be improved.

However, sometimes extra procedures  should be specifically applied to  the muscles to create ease and balance  in the muscular system. Massage  techniques that focus on tight muscles
in the area of symptoms have also been  shown to reduce pain,4 enhancing the  already positive effects granted by the  chiropractic adjustment.
Finally, if the stress and strain on the  upper back is caused by weak postural  muscles, exercising and stretching will  also be recommended as an effective  tool to support your proper spinal
alignment long-term.5 Many chiropractors  are well-versed in the protocols of  posture correction and others rely on  allied professionals to help instruct  their patients in these areas. Discuss  what your best options are with your  chiropractor.
With chiropractic adjustments and  advice, upper back pain can be lifted  from your shoulders.