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Rib and Thoracic Spine Pain can Linger!

The lumbar region in regards to the rest of th...

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The thoracic spine (where the ribs are) is less vulnerable to injury when compared to the cervical or lumbar spine (neck or low back) as it is attached in back to the ribs which then wrap around under the arm to the sternum or breast bone in front.  This forms a very stable circle to protect the heart, lungs, and liver from injury.  While the cervical or lumbar spine may become rotated or stuck in a certain dysfunctional position from simple activities like sleeping wrong or bending over, injuries to the thoracic spine usually don’t occur in this way.

The thoracic spine is more prone to stiffness than the cervical or lumbar spines, again due to its design, fixed in front and back.  Thoracic spine stiffness often has muscle components as well, especially in the upper thoracic spine where the shoulder blades attach to the trunk.  The muscles of the arm extend into the shoulder blade and onto the ribcage.  Many large muscles of the back encompass the thoracic spine and extend onto the arm and in this way cause pain and spasm in the thoracic spine.

Another reason for thoracic spine pain is rib dysfunction.  The hallmark sign of rib dysfunction is pain, sometimes sharp and stabbing, with breathing, coughing, sneezing, or laughing.  Sometimes ribs can move with prolonged coughing due to pneumonia, repetitious lifting, or less commonly with reaching or pulling.

Thoracic stiffness is often treated successfully with joint and soft tissue mobilization.  Ribs are more successfully treated with an Osteopathic technique called Muscle Energy Technique.  This gentle treatment requires the therapist to work together with the patient.  The therapist locates the rib head which is just to the side of the thoracic spine.  The therapist positions the patient’s arm in a place specific to the level of the affected rib, the patient then inhales and pushes her arm against the resistance offered by the therapist.  The therapist pulls laterally at the same time on the rib head.  In this way, the muscle contracts and relaxes which decreases or eliminates the muscle tightness around the rib head at the same time the therapist pulls the rib into or towards the proper position.  Patients are often surprised how effective this simple treatment can be.

Mary Boyd, MS, PT is the owner of Mountain View Physical Therapy and can be reached at 290-5575 for questions regarding thoracic spine or rib pain.  www.MtnViewPT.com.

 

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