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What is Causing my Thoracic Pain?

What is Causing my Thoracic Pain?


The thoracic spine is the largest part of the spine. It runs from the base of the neck to the lower back region, below the rib cage. The thoracic spine is comprised of 12 vertebral bones and is the spinal attachment for the rib cage. It main function is to protect the spinal cord that runs down through the bony vertebral canal of the cervical and thoracic spine, which then branches off into smaller nerve bundles at the end of the lumbar spine. The thoracic spine also protects many vital organs such as the heart and lungs. There are many different causes for thoracic pain.

Causes of thoracic pain:

Here are some of the common and not so common causes of thoracic pain. This is not a complete list.

Intervertebral joint disorder:

This is one of the most common causes of thoracic pain. Typical presentation of this is hypomobility (reduced movement) of one or more intervertebral segments. This may cause local or referred pain.

Muscular problems:

This includes muscles acting on the spine and the scapular area. Myofascial pain, muscular tension and irritation, is a common cause of thoracic pain. Poor posture, sustained positions or postures, poor manual handling techniques or any type of irritation of the back and shoulder muscles can be a thoracic pain cause.


This condition alters the inner structures of bones resulting in bones to become more fragile and therefore, at an increased risk of fractures. Osteoporosis can cause the bones in the spine to lose their structural height resulting in rounding of the upper back and may also lead to thoracic pain.

Dorsal scapular nerve pain:

Entrapment of the dorsal scapular nerve can present as pain between the scapulae (shoulder blades) in the upper thoracic region, pain in the shoulder or arm. The patient may also present with weakness lifting the arm and controlling scapular movement. Other sensations such as itching, burning, tingling, pins and needles or numbness may also be experienced.

Costovertebral joint disorder:

This is the articulation between the spine and the rib. Pain may be caused by an inflammatory disorder known as ankylosing spondylitis, degenerative changes or a mechanical joint sprain. In relation to this area, it is important to also consider a posterior rib fracture.

Scheuermann’s disease:

This is a condition seen in adolescents and is characterised by over pronounced rounding of the thoracic spine. This is due to irregularities of the vertebral end plates in the thoracic spine. Causes include prolonged postures such as flexion. An example of this is extended periods of training on a bike bend over in a flexed spinal position.

Thoracic disk:

Prolapse or herniation of a thoracic intervertebral disk can occur but it is rare.

Other causes of thoracic pain not to be missed are cardiac issues and cancerous tumour. These are not so common but always worth keeping in mind.

Treatment for thoracic pain aims to reduce pain, restore normal range of movement and return to previous levels of function. If you are experiencing thoracic back pain please contact the clinic today to book an appointment. We have trained physiotherapists ready to help you.


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