Thoracic pain can be very painful; patients often describe difficulty taking a deep breath without considerable pain. It is generally the sort of discomfort that comes in sharp waves and feels like a cramp. It is often paradoxically relieved by gentle movement and aggravated by rest. Sufferers often have sleepless nights.

Many GPs regard thoracic onset as a so called Red Flag symptom ie one which would heighten your index of suspicion that there may be a process other than mechanical back pain going on. These other conditions may be osteoporosis,  osteomyelitis (infection of one of the vertebra,) TB and even secondary  or primary cancer. There you go, now I have gone and scared everyone!

Suffice it to say that most thoracic back pain is the result of a problem with the joints of the back or of the ribs that insert into the back joints in the thoracic spine. Is is very rare for there to be other causes like those mentioned above.

The key to managing these conditions is firstly a decent diagnosis, and in some (first episode in those over 55 years, deep throbbing night pain, history of other related pathologies) that may mean an xray. If , as is most probable, a diagnosis of mechanical pain is made then firstly keep moving. Secondly if it is persistent ( more than a week) have some deep tissue massage and manipulation. It shouldn’t take more than a week or two for it to resolve.

I have a number of patients who have had repeated episodes of thoracic pain and we manage them with regular massage, exercise and manipulation. Some of these folks have had Scheuermanns Disease ( a generally self-limiting condition) as teenagers which can often lead to some degenerative changes in the thoracic spine. Some have a minor curvature in the spine which leads to asymmetrical load bearing on the spine and can produce discomfort.

The message to take away is that most thoracic pain is easily remedied with simple measures but it needs to be taken seriously.