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  • Q&A with Australian Health Practitioners

    How can I reduce pain in thoracic spine on cervical flexion.

    Related Topics
    Back & Neck Pain Occupational Health Pain
    I am a dentist with pain in thoracic spine on cervical flexion radiating through upper back, normal MRI scan of thoracic spine and reflexes all intact. Pain completely relieved temporarily( few hours) after massage or physiotherapy manipulation. Had continuous physio (muskuloskeletal-apa) treatment for months, not effective (re: spine pain) but radiating pain is settling (still there) Reduced working hours dramatically. Spine pain gets worst at work and once it starts stays worst for few days. Doing all recommended exercises. what is the next step?
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    Dr Ryan Hislop

    Chiropractor

    Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile

    The spinal cord is not immune to the sustained tension seen with prolonged spinal flexion. Studies have shown the long term impact of sustained neural traction, which in the spine can mimmic radiculopathy.

    The centralising discomfort (i.e. reduction of radicular pain) is promising.

    Often when seeing this condition in practice, emphasis placed on restoring the cervical spine lordosis and postural correction sees favourable results. Postural relief exercises designed to place the spine into a relative extension thorughout the day provides relief during work hours, then an extended home exercise program to continue improving posture at home leads to longer lasting results. Neual flossing/mobilization may also provide some relief.

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    silas

    HealthShare Member

    Thank you Ryan for your reply. I have been shown to do a neural self mobilisation exercise and it has definitely given some relief now, esp during work hours. 

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    Dr Ryan Hislop

    Chiropractor

    Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile

    Great to hear Silas. All the best with your continued recovery.

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    Dr Michael Black

    Chiropractor

    Located in Armadale and Doncaster, Dr Michael Black has an interest in childrens' health and pregnancy. He is passionate aout sharing the benefits of chiropractic … View Profile

    Silas, many years ago I experienced by own challenges in chiropractic practice with continued thoracic pain despite spinal adjustments. At that time a colleague introduced me to the delights of heavy metal and I don't mean music. Working out in the gym doing a lot of chinups and rowing as part of an overall fitness routine beefed up the weak spinal extensors and scapular retractors and save my butt.

    I had always known I needed to beef up but the wake up call came when the continuous pain would not go away. Any manual bodyworker can fall prey to flexion and twisting while working and in this day an age of digital technology and prolonged sitting, a fitness program with real intensity on the core and back is essential.

    I note that your refer to ‘doing all recommended exercises’ and a home exercise program. I would be interested to know what this includes. While yoga, stretching and core strength exercises at home may be of benefit, I wonder if you have been doing any resistance work in the gym? If you cannot do a single chinup, that might be revealing. It may be useful to consult a good personal trainer or exercise physiologist unless you have a physiotherapist who can correctly advise you. Without adequate strength in your middle traps, rhomboids and lats, your occupational duties are slowly going to cause increasing strain.

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    Michael Plush

    Physiotherapist

    Your thoracic pain is not uncommon. I see it regularly in dentists, surgeons, hairdressers etc - this list goes on... anyone who works in prolonged neck / upper back flexed postures, is at risk. The answers already given all form part of the solution: strengthening exercises, stretches, massage, mobilisation and manipulation and maybe a reduction in work-load! What really works well with my patients is a a simple self-management strategy: spinal curve reversal every night: laying on a rolled up towel across the mid back (shoulder blade level) with the hands behind the head and the elbows stretched to the floor (2-5 mins), which streches out the pect muscles, which may have already adaptively shortened. This is followed by a 2-3 firm stretches of the neck and upper back - pulling the chin to the chest (with your hands - NOT A SIT-UP) to stretch the musculo-ligamentous structures of the upper back: this may result in some small self manipulations - good! The towel can be moved up / down a few centimetres and repeated. Good luck!

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