Upper back pain becomes more and more common as people spend increasing time in front of their various screens. Web browsing and social media on your phone, checking the news on your tablet, spreadsheets on the desktop or watching a movie on your laptop all mean sitting, standing or lying with a posture which will sooner or later lead to stiffness and pain in your upper back and shoulders. There is a normal kyphotic curve in the thoracic spine, and everybody varies a bit, however spending a lot of time with an incorrect, usually increased curvature will cause the joints of the spine and ribs to work inefficiently and eventually struggle to work correctly at which point stiffness, tightness, ache and pain begin.

Upper Back
When the thoracic area becomes stiffer, the kyphosis, or ‘roundness’ of the upper back increases, making it harder to rotate and extend to become upright. This leads to the neck and head sitting forward, ‘poke-neck’ posture associated with neck pain and headaches. At the other end, the lower back compensates by rounding more, with associated pelvic anterior tilt, placing more pressure on the lower back joints and especially the discs, which can be problematic for those with pre-existing issues or create issues in those that don’t!

Neck and Lower Back
Mobility through the thoracic spine is also very important to ensure normal function of the neck, lower back and shoulders, as well as ribcage expansion during breathing. The thoracic spine and associated ribcage have relatively good mobility, with a total of about 70° each of bend/extend, rotation and side bend. If these ‘normals’ are compromised for any reason, your body will try to compensate and make up the difference somewhere else, often leading to secondary or other problems in other areas of your body, potentially contributing to neck or lower back pain.

Stiffness in the thoracic spine will cause problems in your gleno-humeral (shoulder ball and socket) joint, as there will be a relative increase in the movement required from the shoulder joint on most arm movements, especially overhead or out to the side. This will in turn lead to increased strain on the soft tissues around the shoulder, such as cartilage or rotator cuff muscles, potentially injury-causing.

Each thoracic vertebra has an associated rib to each side (i.e. 12 thoracic vertebrae, 12 ribs left & right). When the thoracic kyphosis (roundness) increases, the cartilaginous joints between the ribs and the vertebrae become less mobile, which in turn reduces the ability of the ribs and hence the lungs to expand. This limits the potential volume of the lungs, potentially implicating the cardiovascular system, especially during exercise.

A healthy upper back is mobile and moves through normal ranges of movement. It has a neutral aka near ‘normal’ shape (not too flat, curved or twisted) and is strong through the spinal muscles and scapula controllers. Any variations of these will lead to aches, pains or worse!

Written by Tom Sheehan –  BA (Sp & ExMgt), BAppSci (Ex & SpSci), MPhty, APAM

If you are suffering from thoracic, neck or back pain or any other musculo-skeletal complaint, then the staff at Northside Sports Physiotherapy can guide and assist you.

Call your nearest practice to book in an appointment:

Hornsby – 9476 1666

Wahroonga – 9489 4588

Lindfield – 9489 4588