Middle back pain: aka Thoracic Spine Pain

We continue to see lots of patients suffering with pain in the middle section of their back.  These patients have often had worsening pain in the area across days or weeks before they come and see us.  This article will help to explain the role that physiotherapy can play in management of thoracic spine pain.

Anatomy 101:
The thoracic spine, located in the mid-back region, consists of 12 vertebrae (T1-T12) that connect to the ribs, forming the thoracic cage. This part of the spine plays a pivotal role in maintaining stability and supporting our body's movements, acting as a bridge between the cervical and lumbar regions.

Common Sources of Pain:
Poor Posture: Modern lifestyles often involve prolonged sitting, hunching over screens, or slouching. This can lead to poor posture, causing strain on the thoracic spine and surrounding muscles.

Muscle Imbalances: Weakness or tightness in the muscles supporting the thoracic spine can disrupt its natural alignment, contributing to discomfort.

Herniated Discs: Although less common in the thoracic region compared to the cervical or lumbar spine, herniated discs can still occur, leading to localised pain and potential nerve compression.

Overuse or Repetitive Movements: Activities involving frequent rotation or lifting can strain the thoracic spine, leading to pain and dysfunction over time.

How Physiotherapy Helps:
A skilled physiotherapist will conduct a thorough assessment to identify the root cause of your thoracic spine pain. This may include analysing your posture, muscle strength, and range of motion.  Treatment techniques will include:/

Targeted Exercises: Physiotherapy involves tailored exercises to address muscle imbalances, strengthen supportive muscles, and improve posture. These exercises aim to restore proper alignment and alleviate pain.  We love our back balls for this section of the spine as they are a great way to self-mobilise the spine at home between physio visits.  

Manual Therapy: Hands-on techniques, such as massage and joint mobilisation, can help release tension in tight muscles and improve the mobility of the thoracic spine.

Posture Education: Your physiotherapist will provide guidance on maintaining good posture during daily activities and offer ergonomic advice to prevent future issues.

Pain Management: Physiotherapy may include modalities such as heat or ice therapy to manage pain and reduce inflammation in the affected area.

Thoracic spine pain is a condition where traditional physiotherapy techniques remain highly effective.  Manual therapy and soft tissue therapy along with mobility exercises targeting the area will all help.  We love treating this part of the spine as we can generally start to make a big difference in your pain quite quickly.  If you have middle back pain, stop suffering, we are here to help.  

Usually, in a short block of treatment across 2-4 weeks, we can see a significant improvement in your middle back pain.

Unravelling the role of the SIJ (Sacroiliac Joint) in lower back pain

Lower back pain can be debilitating and can affect individuals from all walks of life, including (but not limited to) office workers, athletes, stay at home parents and those working in heavy industries. While there are multiple factors that can contribute to lower back pain, one often overlooked source of pain is the sacroiliac (SI) joint. 

In this article, we'll delve into the sacroiliac joint and its relationship to lower back pain, shedding light on how understanding and addressing any dysfunction present at this joint can alleviate discomfort and improve quality of life.

Understanding the Sacroiliac Joint
The sacroiliac joint (SIJ) is found between the triangular bone at the base of the spine, known as the sacrum, and the ilium, which is part of the pelvis. This joint connects the spine to the pelvis and plays a crucial role in supporting and transmitting forces between the upper body and the lower extremities. It also provides stability while single limb weight bearing and allows for limited movement, primarily in the form of subtle rotations and tilting.

The Impact of Sacroiliac Joint Dysfunction on Lower Back Pain
When the sacroiliac joint becomes dysfunctional or experiences imbalances of muscular tension and weakness, it can contribute to lower back pain. 

Here's how sacroiliac joint dysfunction affects lower back pain:

Addressing Sacroiliac Joint Dysfunction to Relieve Lower Back Pain:
To alleviate lower back pain associated with sacroiliac joint dysfunction, a comprehensive approach that focuses on restoring joint function, releasing and strengthening surrounding muscles, and restoring optimal movement patterns is crucial. A management plan will consider the following strategies:
1. SIJ Stabilization Exercises:
Engage in specific exercises that target the muscles supporting the sacroiliac joint, such as bridges, clamshells, bird dogs and dead bugs. These exercises can enhance stability, improve joint function, and alleviate lower back pain when done with the correct technique.

2. Manual Therapy:
Seeking the expertise of a healthcare professional, such as a physiotherapist can be beneficial. They can provide manual therapy techniques, such as joint mobilisation or manipulation, to restore proper alignment and function of the sacroiliac joint and lumbar spine.
3. Postural Awareness and Ergonomics:

Pay attention to your posture, both during daily activities and while sitting at your desk. Ensure that your workstation is ergonomically optimised to support proper posture, including using a supportive chair and maintaining a neutral spinal alignment.  If you are someone whose occupation involves hazardous manual handling such as repeated lifting then making sure your technique is optimal will effectively help to  prevent lower back injuries.

4. Activity Modification and Rest:
If certain activities or movements exacerbate your lower back pain, consider modifying or avoiding them temporarily. Rest periods and gentle stretching can also help alleviate symptoms and allow for healing.

The best solution is to see us for a physiotherapy assessment so that we can conduct a thorough evaluation, provide personalised advice, and administer targeted treatments to address joint dysfunction and alleviate your lower back pain effectively.  We are always more than happy to help so don’t feel you have to put up with your annoying pain any longer.