Chiropractic Care of the Upper Back

There are many sources of dysfunction in the upper back (thoracic spine) especially when we consider the numerous joints and the interlacing of muscles that comprise the thoracic spine and rib cage. If one muscle or joint is injured or inflamed, it can create a cascade of pain and dysfunction that can be difficult to treat.

Chiropractic treatment and upper back pain

The mid and upper back is known as the thoracic spine, it is the largest portion of the spine, consisting of 12 of the 25 spinal bones (vertebrae). In comparison the neck (cervical spine ) has 7 vertebrae while the lower back (lumbar spine) has 5 vertebrae articulate with ribs and together protect the thorax, hence the name, thoracic spine.

Upper back pain is a phenomenon that affects all age groups. Upper back pain while common receives much less attention than neck and lower back pain.

Thoracic disc herniation

Due to the limited motion in the thoracic spine, caused by the bony barrier of the ribs, Thoracic disc herniations are relatively rare. But when they do occur, they can create much pain and dysfunction.

Whenever practical and safe, conservative (nonsurgical) care, such as chiropractic, is advisable prior to the use of more invasive procedures, such as spinal injections or surgery.

The goal of the chiropractic treatment of thoracic disc herniation is to reduce pain and dysfunction while the body heals itself.

Since most disc extrusions naturally regress in a few months, chiropractors will attempt to reduce the pain and pressure caused by the disc herniation.

Some chiropractors will recommend nutritional support to reduce the pain and swelling associated with a disc herniation.

Myofascial pain syndrome

Fascia is a layer of connective tissue that contributes to the supportive structure of the spine and musculoskeletal system. The fascia invests or surrounds the muscles and allows for the smooth gliding of one muscle upon another. Investing fascia helps to prevent muscles from adhering to each other.

With injury, chronic postural stress or overuse, myofascial trigger points or myfascual adhesions may develop – all commonly referred to as myofascial pain syndrome.

Chiropractors treat myofascial pain syndromes such as myofascial trigger points or adhesions with manual myofascial therapy. This therapy normally includes the use of direct pressure upon the trigger point, or the use of active anchor and stretch myofascial release techniques.

Joint dysfunction

The thoracic spine is a marvel of joint interaction and complex motion patterns. Composed of a total of 220 separate joints, it makes up the lion’s share of the 313 total joints in the entire spine. With this many interactive articulation it is east to see that maintaining normal joint function, motion and position is important. Chiropractors treat thoracic joint dysfunction with chiropractic adjustments.

There are a variety of chiropractic adjustments techniques that can be used to adjust a dysfunctional joint:

                Most chiropractors employ manual adjusting techniques that utilize precise thrusting adjustments to help normalize joint function.

                Chiropractors can also use softer directional adjusting techniques or adjusting instruments to accommodate the needs of the patient

Thoracic outlet syndrome

Thoracic outlet syndrome is a disorder in which the nerves of the brachial plexus and blood vessels are compressed. This compression can cause great pain and altered sensations such as a “pins and needles” sensation in the hands.

Treatment of thoracic outlet syndrome can include stretching, manual trigger point therapy and myofascial anchor and stretch release techniques to the affected muscles. Chiropractors may also include adjustments and postural instruction.

Thoracic /shoulder dysfunction

The function of the shoulder and the upper back are interrelated. Studies have shown that thrusting manipulations applied to the thoracic spine and ribs have reduced should pain and dysfunction. Chiropractic adjustments to the thoracic region can be beneficial to certain types of should dysfunction.

There are many causes and treatment options for thoracic spine disorders. Chiropractors have a wide range of treatment options for treating these conditions. Chiropractors are increasingly joining collaborative spinal care teams as a drug-free option for treating spinal and musculoskeletal conditions. 

Adapted from Spine-Health.com Newsletter