Nobody wants to be a hunchback! Part 1

Is the fear of developing a hunchback in your mind? Let’s take a look at the thoracic spine. The thoracic spine gets looked over quite a bit. However, it is a portion of your spine that is very important!

Anatomy

The thoracic spine is the longest region of the spine, and possibly the most complex. Connecting with the cervical spine and the lumbar spine below, the thoracic spine runs from the base of the neck down to the abdomen. It is the only spinal segment attached to the ribs. The thoracic spine has 12 vertebrae, T1 down to T12. It is the sturdy portion of the spine. It supports the neck, the rib cage, soft tissues, flexible joints, blood vessels, and nerves. While the cervical spine and lumbar spine are built more for mobility, the thoracic spine is built more for stability. The spine has natural curves that allow us to have the most mobility as possible. The curve in the thoracic spine is called a kyphosis curve which means that the spines curves outward towards the back of the body to allow more room for the internal organs such as your heart and lungs. The cervical spine and lumbar spine have opposite curves that curves inward.

The thoracic spine’s most important roles include:

• Protect the spinal cord. The spinal cord is a critical bundle of nerves that sends electrical signals throughout the body. It runs from the base of the brain down through the bony vertebral canal of the cervical spine and thoracic spine before branching into smaller nerve bundles in the lumbar spine.

• Anchor the rib cage. The rib cage, supported by the thoracic spine in the back, forms a bony structure to surround and protect vital organs, such as the heart and lungs.

Thoracic Spine Range of Motion

While the thoracic spine is less mobile than the neck and lower back, the range of motion can vary considerably at different thoracic vertebral levels. Most levels of the thoracic spine have limited forward/backward and side-bending movements but significantly more ability for rotation. These dynamics are essentially flipped near the bottom of the thoracic spine with increased range of motion for forward/backward and side-bending movements but a reduced ability for rotation.

Now that we know how the thoracic spine looks and moves we can dive into what can cause pain and that hunchback look.

Common Causes of Thoracic Spine Pain

Upper back pain is typically due to one of the following:

• Muscular problems. Upper back pain is most commonly caused by muscular dysfunction or tightness. The cause may be poor posture (such as forward head posture) or any type of irritation of the large back and shoulder muscles, including muscle strain or spasms.

• Joint dysfunction. Thoracic spinal joints can become painful in various ways. For example, cartilage tears and degeneration can develop in the facet joints where adjacent thoracic vertebrae articulate with each other. It is also possible for a rib to become misaligned or displaced from the vertebrae. In many cases, facet joint degeneration (osteoarthritis) and degenerative disc disease can happen at the same time. Hypomobility (limited movement) of thoracic vertebra can cause pain and lead to additional issues with musculature and range of motion.

• Posture.

  • Sitting at a computer without proper positioning

  • Looking down at phone/iPad/book

  • Rounded shoulders

  • Forward head

  • Slouched standing and sitting posture

How Thoracic Vertebrae can Contribute to Pain

• Trauma: An accident could cause a rib or vertebrae to break, fracture, or become displaced

• Osteoarthritis: wear and tear within the joints can lead to the breakdown of cartilage, resulting in inflammation, bone spurs, and pain

• Osteoporosis: bones weaken with age, especially in women. Thoracic vertebrae are the most likely to develop compression fractures that can become painful.

• Kyphosis: thoracic spine can become hunched forward too much, called kyphosis. The more extreme kyphosis, the more likely that it can stress muscles to cause upper back pain.

• Scoliosis: abnormal side to side spinal curvature is another cause of pain in the upper back if severe enough

• Thoracic spine can become painful in other ways as well, such as from infection or other forms of arthritis.

Stay tuned for my next post to discuss how to keep your thoracic spine mobile, pain free, and decrease the chance of developing that hunchback look!

Disclaimer: I am in no way diagnosing anyone, if you have persistent pain you need to call your local physical therapist and schedule an appointment.