Spine Health & Spinal Hygiene

The thoracic spine known as the middle back starts below the cervical or neck spine at around the level of the shoulders. It continues down to the first level of the low back or lumbar spine. There are twelve vertebrae, numbered T1-T12 top to bottom, and it is these vertebrae that make up the thoracic spine. When seen from the side, a normal forward curve can be seen.

The ribs are attached to the thoracic spine’s vertebrae making this region of the spine strong and stable. However, this area has less range-of-motion than the neck region. Because of its location, the thoracic spine deals less with injury/s than other areas of the spine. But it is the most common area for fractures from osteoporosis. Scoliosis and abnormal kyphosis are also thoracic spine disorders.

Getting to know the body's spine and how it functions can help individuals have a better and thorough understanding of possible causes to upper and middle back pain, a doctor’s diagnosis, and the reasons for how simple lifestyle changes/choices can keep the middle back, as well as, the rest of the spine healthy.

Thoracic Support

The thoracic spine gives support to the torso, chest and provides an attachment point for each of the rib bones, minus the two at the bottom. The vertebral bodies are rounded with bony arches that project from the back of each and form a hollow protective space for the spinal cord. Facet joints are paired at the back of each and allow for limited movement.

Intervertebral Discs

There is a fibrous pad called an intervertebral disc that is held in place by the endplates between each level’s upper and lower vertebral bodies. Each disc acts like a spacer creating disc height/space between the upper and lower vertebrae. This space opens nerve passageways called a foramen or neural foramina at both sides. Nerve roots branch off the spinal cord and exit the canal through the neural foramina.

Soft Support Structures Limited Movement/s

The entire spinal column consists of:

• Ligaments
• Tendons
• Muscles

These soft tissues attach to the bones, the discs, and work together to stabilize the midback when resting and when in motion. Ligaments are the strong bands of tissue that connect/protect the vertebrae, discs, provide stability, and help with excessive movement. Muscles hold the body upright and allow spinal flexion which is bending forward, extension bending backward, and rotation twisting from side to side. And the tendons are fibrous tissues that attach the muscle/s to the bone.

Nerves Role

The twelve pairs of nerve rootlets that branch off the cord through the neural foramen are to supply and generate sensation/feeling along with function/movement to the body. These nerves provide nutrients to the midback and chest area and relay signals between the brain and major organs, including:

• Lungs
• Heart
• Liver
• Small intestine

Spinal Disorders

• Osteoporosis raises the chances of a thoracic fracture. A vertebral compression fracture can cause one or more bodies of bone to flatten or become wedge-shaped creating spinal cord/nerve compression. Sudden and severe back pain can be associated with vertebral compression fractures.

• Scoliosis is an abnormal side to side curvature of the spine and is well known to develop in the thoracic spine causing deformity.

• Abnormal kyphosis means the forward curvature has become extreme. The appearance of a kyphotic deformity can be seen as a hump.

Types of kyphosis:

• Congenital or appearing at birth
• Posture related
• Scheuermann’s disease
• Metastatic cancer where it travels from the chest, or lung causing spinal tumor/s that can develop and potentially lead to structural deterioration
• Thoracic disc herniations are not common because of the middle back's strength and stability created by the ribcage.

Spine Maintenance

Talk with your doctor, chiropractor, spine specialist about stretches and exercises that will work for your specific situation to strengthen the core, and middle back musculature. This will help significantly with injury prevention during flexion, extension, and rotation.

• Pay attention to posture
• Learn to use proper body mechanics
• Quit smoking/vaping
• Healthy diet
• Learn about the risks for osteoporosis and talk with your doctor about a preventive bone maintenance plan.

Back Pain Specialist

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Back pain is just one of the very typical reasons people self-address and seek medical care. It will impact about three in four adults throughout their lifetime. About “back pain” when we speak we mean pain that originates in the backbone anywhere between the upper and lower back.

There are lots of various kinds of pain. Acute back pain is described as acute but lasting a brief period of time. Chronic back pain usually occurs every day. It could be severe, but may be characterized as mild, heavy, achy, burning, or electric-like. Back pain that travels into a different portion of the body, including the leg may be consider radicular pain, especially when it radiates below the knee. This scenario is often called a lumbar. Fortunately, not all incidences of back pain include leg pain!

It isn’t uncommon for back pain to be accompanied by other symptoms, like numbness and tingling senses, stiffness, achiness, and weakness. Back pain may raise or aggravate. Twisting at the waist, walking, standing, bending over, and sitting are some of the motions that may make back pain worse. Of course, that’s not true for each patient. Instead, it depends on what level of the back is changed and the analysis, or cause.

BACK PAIN DOCTOR – SPEAK

If you see a doctor for back pain, he (or she) may use terms such as thoracic, lumbar, lumbosacral, or sacrum. The purpose is, back pain is a big subject covering many distinct regions (or amounts) of the backbone.

• Lumbar refers to your low back.
• Lumbosacral is the low back, sacrum, and maybe the tailbone (called the coccyx).
• Sacrum is the section of the spine that is at the back of your pelvis.

Furthermore fibrous and muscle supporting structures, intervertebral discs, spinal cord and nerve roots, and blood vessels. A straightforward injury, such as a back sprain/strain from lifting and twisting simultaneously, can cause severe and immediate pain that’s usually self-limiting.

Of course, not all prevalence of back pain are injury or trauma -associated. Many back problems are congenital (discovered at birth), degenerative, age-associated, disease-related, and may be linked to poor posture, obesity or an unhealthy lifestyle including smoking. Occasionally the back pain is worse than the seriousness of the harm or illness.

• You cannot stand upright.
• Pain is accompanied by fever.
• Loss of bowel or bladder function or control
• Weakness leg pain and/or progressively worsens.
• Pain is worsens or persistent.

Many patients with back pain have reported feeling concerned and scared, which is regular. Most individuals who experience upper, low or lower back pain— even down into both legs or one — know when it’s time to seek medical care.

WHAT TO EXPECT FROM YOUR PHYSICIAN

Whether you back pain falls into the “seek pressing medical care” list above, or you’re following your gut reaction that says, “Go see your doctor,” below is what you are able to expect.

A review of your medical history, including immediate family members who have back problems. Some back problems (eg, scoliosis, osteoporosis) have a genetic possibility.
Your physician wants to learn as much about symptoms and your pain before he examines you—while the exam may induce pain, your physician doesn’t wish to make the process intolerable!

Physical examination evaluates your vital signs (eg, heart rate). It really is not unusual for your blood pressure to be elevated as an effect of pain. The doctor examines your spine, feeling for abnormalities and regions of tenderness.

Neurological examination involves evaluating function and sensation. The physician may apply the pin prick test to determine if feeling is the same on either side of special portions of the body (eg, legs). Function, flexibility and range of motion are evaluated while you walk, bend forward and backwards (if able to), and during other movements. The physician tests your reflexes also.

After an exhaustive review, your doctor probably has come to a couple of conclusions as to what is causing your back pain and other symptoms. To obtain more information about your back problem, and to assist confirm the diagnosis, the doctor may order an x ray, CT scan, or MRI. Occasionally lab tests are purchased also. Bear in mind that an exact diagnosis is vital to a well-developed treatment plan.