Upper & Middle Back (Thoracic Spine)

A thoracic interspinous ligament sprain refers to the stretching or tearing of the interspinous ligaments in the thoracic spine. These ligaments connect the spinous processes of adjacent vertebrae and play a crucial role in stabilizing the spine and limiting excessive motion.

A thoracic interspinous ligament sprain may occur due to repetitive movements, trauma, poor posture, and sports injuries. It can be treated with bracing, pain medications, and physical therapy to alleviate pain, swelling, stiffness, and muscle spasms, but these ligamentous injuries can also be visualized under ultrasound and precisely treated with an injection that stimulates repair of the injury.

A thoracic paraspinal muscle strain refers to an injury to the paraspinal muscles that run along either side of the thoracic spine. These muscles play a crucial role in supporting the spine and the shoulder blades (scapulae), maintaining posture, and facilitating movement.

The muscle strain can be caused by sudden movements, trauma, repetitive activities, and sports injuries. Massage, physical therapy for slow progressive strengthening exercises, pain medications, and gentle stretching exercises can help alleviate the symptoms.

Thoracic radiculopathy is a condition in which a nerve root in the thoracic spine becomes compressed or irritated. A common cause of thoracic radiculopathy is the narrowing of the space where nerve roots exit the spine, resulting from stenosis, bone spurs, disc herniation, or other conditions. It can lead to pain, numbness, tingling, and weakness radiating from the back to the chest and abdominal areas. 

A thoracic disc herniation occurs when the inner gel-like core called nucleus pulposus of an intervertebral disc in the thoracic spine bulges out through a tear in the tough outer layer called an annular tear. 

A thoracic disc herniation can put pressure on nearby nerves, leading to pain in the upper and middle back. It can result from age-related wear and tear of the discs, repetitive stress because of activities like repetitive bending or heavy lifting, trauma, and chronic poor posture.

The symptoms of a thoracic disc herniation are caused by increased pressure on the nerves. The location of pain and discomfort depends on which nerve has been affected in the thoracic spine and whether the intervertebral disc has ruptured enough to put pressure on the spinal cord. If the pressure on your spinal cord is severe, it can cause tingling, numbness, and weakness in your legs.

Thoracic disc degeneration is a condition characterized by the gradual deterioration of the intervertebral discs in the thoracic spine. These discs serve as shock absorbers and allow for flexibility and movement of the spine. 

Degeneration of these discs can lead to pain, stiffness, and reduced mobility. If the disc is severely degenerated, it can lead to the formation of bone spurs that may limit the mobility of the thoracic spine. 

It can also lead to other conditions, such as radiculopathy, thoracic disc herniation, and spinal stenosis, which refers to the narrowing of space around your spine. 

Rib pain or rib dysfunction can arise from various causes affecting the rib cage, muscles, joints, or nerves. Twelve pairs of ribs connect to the thoracic vertebrae in the back and curve around the chest, protecting vital organs, such as the heart and lungs.

Rib dysfunction usually involves a problem at the joint between the rib head and the thoracic spine. It can cause pain due to improper gliding and tightness in the muscles around the scapula that attach to the various ribs, causing jamming of the rib head at the costotransverse joint. Other causes may include muscle strain from overuse, rib fractures, inflammation of the cartilage, and partial dislocation of a rib.  

Scapular dyskinesis refers to an abnormal movement or positioning of the shoulder blade, also called scapula, during shoulder motion. Although the condition itself may not be painful, it increases the risk of injury, particularly neck and shoulder pain.

Scapular dyskinesis may be caused from:

• Damage to your nerves
• Loss of flexibility
• Damage to your muscles and adjacent connective tissue called fascia
• Weakness in your core, hips, or scapular muscles
• Weak bones or bone fractures‌
• Injuries to your joints

Scapular dyskinesis may worsen due to chronic inflammation, injury to the rotator cuff muscles, and poor technique when throwing or lifting.

Periscapular muscle strains refer to injuries involving the muscles and fascia surrounding the shoulder blade. These muscles help stabilize and move the shoulder joint, and strains can result from overuse, trauma, or improper movement patterns.

Discomfort and pain in the area surrounding your shoulder blade may also radiate into the neck, aggravated by movement or pressure.