Mid thoracic pain is most commonly caused by facet inflammation in areas of the thoracic spine. This can be due to prolonged sitting such as with breast-feeding or desk work. Other causes of mid thoracic pain might be due to condition seen in adolescents called Scheuermans disease, which is relatively rare, but can be diagnosed via spinal xray.
Upper crossed syndrome or postural neck pain can present as chronic neck and/or arm pain and is usually caused by a persistent ‘slumping’ posture. This usually results in the development of tight upper trapezius, levator scapulae and pec major muscles. Antagonist muscles of the rhomboids, erector spinae and deep neck flexors additionally become weak and stretched. The shoulders become rounded (gothic shoulders), the head moves forward (anterior translation). This creates pressure and hypomobile joints at particular areas through the thoracic and cervical spine. Eventually a ‘flat back’ may occur as the thoracic spine becomes locked and hypomobile.
Chiropractic management of mid thoracic and postural neck pain involves restoring motion in the hypomobile segments, stretching and relaxing the tight muscles through passive stretching and trigger point therapy. Once function is restored, home exercises are crucial in maintaining function and usually involves a combination of stretching and strengthening.
Ergonomic and postural advice is also given to help reverse the poor posture along with advice on a good cervical pillow for sleeping. With chiropractic treatment, prognosis (recovery) is usually excellent with compliance in physical and postural activity modification.
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