Conditions We Treat

Thoracic Back Pain

Thoracic Back Pain - APSM

What is Thoracic Back Pain?

Thoracic back pain is pain that occurs in the thoracic spine, which is located at the back of the chest (the thorax), mostly between the shoulder blades. It extends from the bottom of the neck to the start of the lumbar spine, roughly at the level of the waist.

What causes Thoracic Back Pain?

Muscle or soft tissue inflammation in the thoracic area is the most common cause of thoracic back pain.  This can occur for a number of reasons:
  •  A sudden sprain or strain (as in car accidents or sports injuries).
  •  Sitting or standing in a slouched position for a long time.
  •  Using a backpack.
  •  Sitting for a long time at a computer.
  •  Lack of muscular strength (couch potatoes beware!).
  •  Repeating a movement persistently that involves the thoracic part of the spine (as in sport or work): also called overuse injury.
  •  Narrowing of part of the spine (thoracic spinal stenosis or narrowing of the spinal canal ) – usually due to wear and tear. Slipped discs – these are common but rarely cause pain. Fractures of the vertebrae (the bony components that make up the spine). Bone thinning.
  •  Spinal infection.
  •  Spine joints Arthritis.
  •  Ankylosing spondylitis – inflammation of the joints between the vertebrae.
  •  Scheuermann’s disease – an inflammation of the joints of the spine which results in spinal curvature.
  •  Spine tumors.
  •  Shingles.
Other causes of pain in this area can include problems affecting the lungs, the upper part of the gut, the stomach, the gallbladder and the pancreas.

What are the symptoms of Thoracic Back Pain?

While persistent Thoracic spine pain is common, short-lived and of little consequence, it is also more likely than neck pain or low back pain to have a serious cause. If you have thoracic spine pain, watch out for the following:
  •  Recent serious injury, such as a car accident or a fall from a height.
  •  Minor injury or even just heavy lifting in people with ‘thinning’ of the bones (osteoporosis).
  •  Age under 20 or over 50 years when the pain first starts.
  •  A history of cancer, drug misuse, HIV infection, a condition that suppresses your immune system (immunosuppression) and use of steroids for a long time (about six months or more) e.g.  for treatment of Asthma or Rheumatoid arthritis.
  •  Feeling generally poorly – for example, a high temperature (fever), chills and unexplained weight loss.
  •  A recent infection by a germ (bacterial infection).
  •  Pain that is there all the time, severe and getting worse.
  •  Pain that wasn’t caused by a sprain or strain (non-mechanical).
  •  Pain that doesn’t get better after 2-4 weeks of treatment.
  •  Pain that is accompanied by severe stiffness in the morning possibly arthritis.
  •  Changes to the shape of the spine, including the appearance of lumps or bumps.
  •  Pins and needles, numbness or weakness of the legs that is severe or gets worse over time.
  •  Difficulty to control the bowel or the urine (can indicate pressure on the spinal cord).
Due to the fact that persistent thoracic back pain is more likely to be serious if it occurs in the thoracic area rather than in your neck or lower back, your doctor is likely to suggest tests if the pain persists, is severe, or is accompanied by any of the ‘red flag’ features mentioned above. The tests will depend on the conditions that the doctor wants to rule out. It’s likely to include blood tests and imaging like an MRI. An ordinary plain X-ray doesn’t give much information unless you have an unusual appearance (scoliosis or kyphosis) of the spine or a fracture.

What are my treatment options for Thoracic Back Pain?

  •  You may not need any treatment as many cases settle down without it.
  •  If you have an underlying cause, this will need to be treated.
  •  If the pain is coming from a joint in the spine (a facet joint) this may be helped by an injection performed under X-ray vision (fluoroscopy) 
  •  Surgery is used only as the last resort.
  •  The prognosis depends on the underlying cause, your age and your general fitness.
Many cases resolve on their own in a few weeks, but it should be remembered that pain in the thoracic spine pain might have a serious cause.

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Common Conditions We Treat