What is causing my thoracic spine/upper back pain?
For the spine, there is not always a clear black and white answer of the specific anatomical structure causing thoracic pain/symptoms and patients often get hung up on wanting a firm anatomical diagnosis. While MRIs may show lots of scary words, they are notorious for false positives and often show findings that are likely irrelevant, leading to unnecessary surgeries. A false positive finding means they show findings that are present in the vast majority of the population, including folks with no pain.
Due to this inability to identify an exact structure causing pain, even with an MRI, patients are best treated on a “sign and symptoms” approach. We look for characteristics in your presentation that show you are more likely to respond successfully to certain interventions and exercises.
- “Neck Pain Guidelines: Revision 2017: Using the Evidence to Guide Physical Therapist Practice,” Vol. 47, No. 7, 2017, pp. 511-512. Journal of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2017.0507.
We define patient-centered goals as what you hope to accomplish from physical therapy. While these are typically activity-specific goals, often patients report they just wish to experience less pain.
Spinal manipulations include positioning of a patient and then performing a single, rapid movement to an area of the spine including cervical (neck), thoracic (upper back) and lumbar (lower back).
Kyphosis refers to the normal rounding of the upper back. Occasionally, people will have excessive rounding and in this case the rounding/kyphosis is referred to as hyperkyphosis (hyper = above normal). This rounding increases naturally as we age and there is no standard definition of hyperkyphosis versus normal changes associated with aging. An increase in kyphosis is more common in women than men. The cause of an increase in kyphosis is due to muscle weakness and impairments in flexibility/mobility.