Chiropractic care for Mid Back Pain
While mid back pain can be very severe, it is often fairly simple to diagnose and treat. To better understand mid back pain, it’s easiest to divide it into categories of the source of the pain and the quality of the pain. This is to say, a sharp pain in the midback may be much different than a dull mid back pain.
Table of Contents
Sharp pain under the shoulder blade
The most common mid back pain I treat in my office is a sharp or stabbing pain under the shoulder blade. So what is the cause of sharp upper back pain? Most often I find that it is a rib that is jammed up. Each rib has two joints connecting it to the thoracic spine in back. In front, the rib connects directly to the sternum or in the case of lower ribs, to the costal cartilage which then connects to the sternum.
These joints allow the rib cage to expand and raise up and down as we breath. If either of these motions are restricted, the joints become irritated and inflamed causing pain. Sometimes the inflammation spills over onto the intercostal nerve between the two ribs or the nerve is pinched by the ribs. The simple solution to rib pain is to restore movement to the rib joints. This can be done with chiropractic adjusting, however, not all chiropractors check the ribs and adjust them. In my experience, I find more joint dysfunction in the ribs than in the thoracic spine itself.
Another important question to ask is; How do rib joints get jammed up? If there is some kind of trauma, the cause is obvious, but sometimes, they just start hurting. In these cases, the cause is most likely joint dysfunction in other areas of the body. There are very strong muscles that attach to the ribs and mid back from both above and below. These muscles will adapt to misalignment elsewhere in the body to keep us upright. Over time, the tension on the ribs can cause them to lock up. You may get very quick relief from sharp pain under the shoulder blade aka rib pain with a rib adjustment, but often that’s just relieving the symptom. To really solve the problem you need chiropractic care for the whole frame.
Sometimes people worry that this might be a heart attack. Mid back pain is one possible symptom of a heart attack, especially in women if it comes with other symptoms of heart attack such as shortness of breath, nausea, sweating, light headedness, stomach, chest or neck pain. Though usually heart attack related upper back pain is experienced as a dull pain or tightness around the chest and upper back.
Dull pain in the mid back
Most dull mid back pain is experienced as a chronic ache that comes on later in the day. This pain is from stress on the joints of the thoracic spine. Ligaments are made of fibrous tissue that connects one bone to another. They both support the joints and limit joints to their normal range of motion.
Unfortunately, much of what people do these days contributes to poor posture. We are constantly sitting and either slouching to relax or leaning forward to do things. This really pulls on the ligaments on the back of the spine and puts slack into ligaments on the front of the spine. Over time, the back ones get stretched out and the front ones shrink. Now you have a slouch and it’s hard to sit up straight.
Again, the solution is chiropractic adjusting to loosen up those joints. You can help this process with stretching the muscles of your chest, especially the pecs. Using a foam roller to open up the ligaments of the thoracic spine is also very helpful.
Radiating pain from back to the chest or arm
Most people understand that radiating pain is from pinched nerves. The question is which nerves and where are they being pinched. If the pain starts near your spine and wraps around your ribs, an intercostal nerve is being pinched. These are spinal nerves that come off the spinal cord, travel through spaces between the thoracic vertebrae and between each set of ribs.
Unlike the lumbar spine, the thoracic spine rarely has disc herniations. As we get older, pretty much everyone gets some disc degeneration in the thoracic spine. So it’s possible the nerve is being pinched at the spine, but if you are under 60 and have relatively good posture, it’s more likely being pinched by a rib. Again, this can be an easy short term fix, but may need more attention to the overall frame to clear the underlying cause.
If the pain starts just below your neck and goes into your arm, it’s a bit more complicated. In this case, you may have a bulging disc in your neck. This situation responds well to chiropractic adjusting and traction. Nerves from the lower part of your neck and upper thoracic spine also travel through a space between your first rib and your collar bone before traveling down your arm to you hand. A pinch here may be caused by one of several muscles that cross over the nerves or trouble with the first rib or collar bone. This is called Thoracic Outlet Syndrome. A combination of chiropractic adjusting, muscle work and stretching can eliminate TOS.
Sometimes people worry that this might be a heart attack. Mid back pain is one possible symptom of a heart attack, especially in women if it comes with other symptoms of heart attack such as shortness of breath, nausea, sweating, light headedness, stomach, chest or neck pain. Usually heart attack related upper back pain is experienced as a dull pain or tightness around the chest and upper back.
Middle back pain red flags
In addition to mid back pain being a possible symptom of a heart attack there are several other conditions possible that would need medical attention. These are much less common than the simple joint dysfunction that responds well to chiropractic care. Some of these conditions can be seen on x-ray such as compression fracture, bone infection, bone or lung cancer or aortic dissection. The pancreas, kidneys and digestive system can also create referred pain to the mid or lower back. Red flags would be sudden, severe pain, dizziness, pain that never goes away, fever, pain that wakes you up at night or weight loss.
Mid back pain Summary
While mid-back pain is less common than lower back pain or neck pain, it can be just as severe. Chronic midback pain can really wear on a person. Fortunately, most mid back pain can be cleared out with a short course of chiropractic treatment. More involved cases will take more time and attention to the overall biomechanics of the body and ongoing maintenance chiropractic care.
If you are currently experiencing mid-back pain with or without radiating pain into your chest or arm and are in San Rafael CA or Marin County feel free to set up a free phone consultation to discuss your case.
