The upper back or thoracic spine generally speaking, is more stable than the neck and the lower back due to the attaching ribs. Even with this extra stiffness, problems still occur. Below are common things that happen to the mid back or thoracic spine.
Rib Head Pain
This is a very sharp pain. Most patients describe it as knife-like pain. Why does this occur? A little anatomy will help you to understand this. Each rib actually attaches to the spine in two different locations. At each site of attachment, a joint is formed allowing movement. Yes, the ribs move. If it weren’t for this movement, we could not take a breath or bend in this area. Because of these joints, certain movements can create problems. Typically, “extreme” twisting of the upper body will cause these joints to become misaligned or subluxated. When this happens the ligaments that surround the joints (joint capsule) become stretched and on occasion pulled inside the joint allowing the capsule to be pinched. This is what causes that horrible knife-like pain. Treating this requires a thorough understanding of the anatomy in this area and the skill to adjust the rib head(s) back into their proper location.
There are a variety of things that cause compression fractures; some are insidious others are sudden due to trauma.
• Insidious causes – A weakening of the bone due to a demineralization or osteoporosis causes the vertebral body to become vulnerable to compression forces. We have all seen people that have had this type of problem. They tend to become hunch backed. There are various terms for this Gibbus deformity or a Dowager’s hump.
• Traumatic causes – Any sudden forceful forward flexion of the thoracic spine can create forces capable of causing compression fractures. If you have recently been involved in an accident and have deep mid-back pain you need to have this evaluated. This will require x-rays of the involved area.
If a fracture is diagnosed, I will refer the patient to an orthopedist for an evaluation. I have seen several of these over the years. Pain from rid heads however, I see on a regular basis. My treatment is very effective. I have treated many weekend warriors in the greater Cincinnati area that have suffered with rid head problems. As with other musculoskeletal problems the sooner you begin treatment the better.