Painful thoracic spine

Thoracic spine is the least mobile and at the same time the most stable segment of the spine. Problems occurring in this area, are not usual such as cervical spine or lumbar spine problems, however when they occur, they can be very unpleasant.


The reasons why pain affects this part of the spine can be many. Complications are usually caused by functional joint blockage, which forms on the basis of overloaded spine and inappropriate burdening. It can also form from a sudden uncoordinated movement, for example slipping or stepping incorrectly on the foot, when the person is not prepared for this kind of movement. Patients often feel pain and movement restriction. If the restriction happens suddenly, the affected person will notice immediately. But it can also happen that it will go unnoticed, and our organism will try to find compensating mechanisms, which replace for the time being the restricted movement, but in a long run it can cause much more severe problems. In the area of the blocked joint are hypertonic muscles (in higher tension), which are by the touch significantly firmer and painful. These dysfunctions can appear in between the vertebrae or just in one segment (between two neighboring vertebrae). In case of blocked thoracic spine, patients usually feel pain in between the shoulder blades. The pain usually also affects shoulders, sometimes even arms or nape of the neck. If the blockage is lower, the pain then occurs in abdomen.

Blocked ribs are another typical complication connected to thorax problems, but very often it causes changes in relatively distant parts of the body (for example tailbone pain, pain in the knee joints and many more…). In case of thoracic spine, patients usually feel pain around the shoulder blades and shoulders, and shallow breathing is present.


It usually forms during sudden uncoordinated (unideal coordination of single muscles) activity of the back muscles. Patients often feel immediate pain in a certain segment of the spine with one side of the body being affected more. Breathing problems occur as well. The pain can move through armpits to the front side of the chest.


People who suffer from this syndrome have visibly wrong body posture, they suffer from local pain and restricted mobility of this segment of the spine. The pain is provoked by movement, usually by rotation and straightening the spine.


Referred pain is a pain that originates in a different area than in which we sense it. It is often appearing during problems concerned with internal organs. We can observe higher sensitivity and increased muscle tension on the surface of the body, where the internal organs disorders manifest. But we can also find an opposite vertebrovisceral relationship, where the initial cause is a disorder in the movement system, which induces problems in the given organ (for example stomach pain, digestion problems, problems with getting pregnant…).


Pain in the thoracic spine should not be underestimated, especially for their possible connexion with internal organs. Physiotherapeutic options nowadays offer wide spectrum of concepts and methods (mechanical therapy according to McKenzie, Acral coactivation therapy according to Špringrová, DNS method according to Kolář, mobilization techniques according to Lewit and other), how to approach these problems and how to solve them. Physiotherapist should be at the same time able to determine how to treat the problem, or if it’s necessary to seek out medical help.

Instructions for exercises during pain of the thoracic spine and ribs

  • First aid during pain of the thoracic spine and ribs
  • Exercises during pain of the thoracic spine and ribs
  • Exercises during pain of the thoracic spine and ribs with assistance of a second person
  • Exercises during pain of the thoracic spine and ribs with exercising tool

Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: Clinical experience from a private practice in physiotherapeutic field, FYZIOklinika

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