Manual Osteopathy for Middle Back Pain

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The prevalence of middle back pain (thoracic back pain) is as frequent as lower back pain or neck pain, although thoracic back pain hasn't traditionally received the same amount of attention as lumbar and cervical pain.  Therefore, it remains less known to the public that manual osteopathic treatments such as Joint Mobilization, Muscle Energy Techniques (MET), and Soft Tissue Therapy (SST) in addition to exercises, stretches, lifestyle changes and ergonomics can help to reduce pain and improve the range of motion in such cases.

Movement and rotation of vertebrae in the middle back is more restricted than in the neck and lower back. This is due to the fact that in the middle back, part of the attachment of the spinal column and ribs restrict the possible range of motion of these bones. In addition, spinal conditions and abnormalities in this region is rather more pronounced and significant in comparison to lower back (lumbar) and neck (cervical) area, since the spinal cord and nerves in this region supply the intercostal muscles, which help inhalation and exhalation. Therefore it follows that any nerve damage or pathology of the spine can cause serious effects, such as difficulty breathing, which over time can cause serious damages to the visceral organs or central nervous system (CNS).

Thoracic back pain might happen suddenly (such as in trauma, a car accident, whiplash,  or a sports-related injury) or over time (such as having poor posture, repetitive movements, over-bending, or over-rotating). Most of the time the pain is due to soft tissue damage, and it appears due to muscular irritation that might arise from lack of erector-spinae muscle power or other superficial muscle power. Degenerative joint diseases (DJD) such as osteoarthritis of the spine in the vertebral column, and ankylosing spondylitis are the second most common causes of thoracic back pain. In these cases, the joint between each spine gets affected and will cause narrowing of the disc, which might then cause a herniating disc, or in severe cases nerve impingement. The last cause of thoracic back pain might be due to structural deformities, although this happens rarely compared to the first two causes. Hyper-kyphosis, scoliosis and Scheuermann’s disease are the conditions that essentially arise by structural deformity or osteochondroses.

Your manual osteopath can figure out the specific cause of your pain depending on your signs and symptoms after taking a complete medical history, along with a preliminary physical examination in your consultation session. Further treatments then follow in later sessions.

Osteopathic manual treatment offers many techniques to prevent and treat pain in the middle back. Treatments aim to restore normal muscle tone in order to release any muscle tension or nerve impingement, which in turn acts towards mobilization of the vertebral spines to further relieve pain. Also, stretches and exercises along with certain muscle energy techniques can increase the range of motion in the affected area. Almost all patients are greatly satisfied with their hands-on osteopathic treatment due to the gentle and non-intrusive nature of the treatment. Patients often report that treatment has helped to substantially reduce the frequency and intensity of their pain episodes.

By Nazanin Eshghi Moghaddam, DOMP