The thoracic spine, which is also called the upper back or middle back, is very different in form and function to the cervical spine (the neck) or the lumbar spine (the lower back).
We obtain mobility from the neck and lower back but the thoracic spine is designed to be extremely stable and strong to allow us to stand upright, it also protects vital organs such as the heart and lungs.
As this section of the spinal column has a good deal of stability and very restricted mobility, there is usually very little chance of degeneration or injury in the upper back over time. Probably the most common factors that cause this type of pain are joint dysfunction and muscular irritation.
There might have been an injury to a disc in the upper back like a thoracic herniated disc or degenerated disc that produces such related upper back pain, but these injuries are extremely rare.
The word “thoracic” means related to the chest, and the thoracic spine is the section of the spine that corresponds to the chest area consisting of:
Twelve vertebrae in the centre of the spinal column with ribs connected make up the thoracic spine. When viewed from the side, this part of the spine is slightly concave.
Each vertebra in the thoracic spine is attached to a rib on both sides at every level and they in turn meet in the front and connect to the sternum which is also referred to as the breastbone.
This results in a cage (the thoracic cage) that gives structural protection for the vital organs of the lungs, heart and liver, and also creates a cavity for the lungs to expand and contract.
The top nine ribs begin at the spinal column, curve around and are joined at the front of the chest area. As the ribs are firmly attached at the back (the spine) as well as the front (the sternum), they allow for very limited mobility in the spine.
- The lower three ribs do not join together at the front, but do function to shield the vital organs while allowing for slightly more mobility.
- The joints between the bottom thoracic vertebra (known as T12) as well as the top lumber vertebra (L1 in the lower back) allow for twisting movement from side to side.
As there is very little motion and a great deal of stability throughout the thoracic spine, this section of the back does not tend to develop common spinal disorders such as degenerative disc disease, herniated disc, spinal stenosis, or spinal instability. These conditions can cause chronic back pain but are quite rare in the upper back.
Due to this stability and lack of movement, in most cases anatomic causes of upper back pain cannot be identified. An MRI scan or CT scan will seldom image an anatomic problem that is responsive to any sort of surgical remedy for the upper back pain.
Main reasons therefore seem largely to be either joint dysfunction or muscular irritation and any associated treatment should be based on this diagnosis.
Here is where you can get information on lower back pain exercises and other back pain relief products.
Jan Griffiths has carefully researched upper back pain relief and contributes to many online resources to help sufferers as well as maintaining her own back pain blog.
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