07 Tue

Neck pain and the thoracic spine

Neck pain and the thoracic spine

Written by: Paul Kochoa, PT, DPT, OCS, CKTP, CGFI


If you have neck pain, you’re not alone, between 30% and 50% of people in the United States had neck pain last year. We’ve talked about the neck before and how your posture or shoulder may be a culprit, and even a quick fix, but today I want to mention another area that we’ll need to look at as well.

The spine is divided into three sections: the cervical spine (neck), the thoracic spine (mid back), and the lumbar spine (lower back).  The cervical spine and the thoracic spine are connected and one part may play a role in the dysfunction and pain of the other.  It makes sense, we’ve covered how parts of the body are connected to other parts before, the neck and mid back are no different.  With poor posture or injury, your thoracic spine may lose some mobility.  This can affect your cervical spine.  The thoracic spine is further stabilized by the ribs and doesn’t move as much as the cervical spine, so that might be a reason why you’ll feel the symptoms more in the neck than in the mid back.  Also, muscles that attach and control neck movements originate from the thoracic spine.  Another reason why the two segments are related, you can’t have a mobile neck with a dysfunctional mid back.

In the Journal of Orthopedic & Sports Physical Therapy, a systematic study noted how manipulation of the thoracic spine improves range of motion, decreases pain, and increases function in patients with neck pain.¹  Manipulation is a common manual therapeutic technique that physiotherapists, among other medical professionals, use to mobilize joints in the spine. (Side note: chiropractors may try and OWN the term “manipulation”, but physios can do it too.  No one profession owns it.)  However, some people may feel apprehensive to have their cervical spine manipulated, or their “neck cracked”   Thoracic spine manipulation is different.  With very little contraindications or risks for such an intervention, it’s quick and easy to do, with no major downsides.  Manipulation of the thoracic spine may help you.  (Another side note: manipulation doesn’t necessarily have to be accompanied by an audible crack to be successful, sometimes joint manipulation is silent).

The journal article looked at 44 studies, and narrowed it down to six high-quality ones, that investigated manipulation and neck pain.  Improvements were found immediately after the manipulation and lasted up to six months after a three-week physical therapy treatment program. Thoracic spine manipulation is safe and can help you feel better faster.

A physiotherapist can evaluate your neck and determine if you are a good candidate for thoracic manipulation to help get rid of your neck pain.  If you would like more information, please call Professional Physical Therapy and Training at 973-270-7417.  Our offices are located within the YMCA locations in Madison and Summit, NJ.  You do not need to be a member of the YMCA to visit with us.

1. Cross KM, Kuenze C, Grindstaff TL, et al. Thoracic Spine Thrust Manipulation Improves Pain, Range of Motion, and Self-Reported Function in Patients With Mechanical Neck Pain: A Systematic Review.” J Orthop Sports Phys Ther 2011;41(9):633-642.
Image courtesy of sixninepixels / FreeDigitalPhotos.net

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