Acute & Chronic Thoracic Spine Pain

Thoracic Spine Pain- Evaluation & Treatment

Thoracic pain can be:

  • Constant, severe and progressive.
  • Non-mechanical without relief from bed rest or postural modification.
  • Unchanged despite treatment for 2-4 weeks.
  • Accompanied by severe morning stiffness


The beginning of any evaluation should begin with an inspection. Examine the problem area and taking note of any swelling or tenderness as well as assessing for deformities, asymmetry or pelvic tilts. Observe the way the patient walks and sits to assess for abnormalities in their gait. Evaluate normal ranges of movement and if the patient exhibits any limitations as well as an examination of the shoulders and hips as they work as one system with the spine and can have an affect on one another. With palpitation, check for bone tenderness. This is important as it can indicate fractures or other more serious pathology. As the patient to test range of motion in a seated position to see how far forward they can lean before they feel pain.

Importance of Manual Therapy – Treatment.

In general, many physicians or surgeons will prescribe physical therapy to their patients, but those who seek out physical therapy for common discomforts and pains such as thoracic pain have a harder time attaining access and, more importantly, coverage for these visits. Manual Therapy is taught in school, but it can go so much further than what is taught in the classroom. Methods and techniques are always evolving to benefit the patients and help further their recovery as quickly as possible with lasting results. Limitations of mobility and range of motion can cause pain and alterations in posture and movement- sometimes permanently. Manual therapy can restore mobility to stiff joints and reduce muscle tension in the spine in order to give your patient back natural movement without pain. Physical therapy sessions can provide relief from soft tissue injuries such in the back from muscle strain or pulled ligaments, both common in the spinal region and specifically to the mid-back. Various “patient reports support the assertion that manual physical therapy can be effective in relieving back pain for certain patients.” Close to 90 percent of people will, at some point in their lives, experience some form of back pain. Of this, up to 20% may suffer from thoracic back pain [3].

“Compared to the lumbar and cervical spine, the thoracic spine has received less attention in terms of clinical, genetic and epidemiological research, yet pain experienced in the thoracic spine can be equally disabling, imposing similar burdens on the individual, community and workforce” [1] The lower back and neck region both receive a lot of attention for being common locations of pain and discomfort among many people of various ages. However, we neglect to shine a light on the thoracic spine, or middle of the back, when it too is subject to aches and pains. According to the Journal Of Manual & Manipulative Therapy, manual therapy for the Thoracic region of the spine has proven “accelerated recovery and reduced pain and disability immediately for up to 52 weeks” when compared to other forms of treatment or care [2].