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A Comprehensive Look at the Thoracodorsal Nerve

A Comprehensive Look at the Thoracodorsal Nerve

Individuals experiencing pain symptoms like shooting, stabbing, or electrical sensations to the latissimus dorsi of the upper back could be caused by a nerve injury to the thoracodorsal nerve. Can knowing the anatomy and symptoms help healthcare providers develop an effective treatment plan?

A Comprehensive Look at the Thoracodorsal Nerve

Thoracodorsal Nerve

Also known as the middle subscapular nerve or the long subscapular nerve, it branches out from a part of the brachial plexus and provides motor innervation/function to the latissimus dorsi muscle.

Anatomy

The brachial plexus is a network of nerves that stem from the spinal cord in the neck. The nerves supply most of the sensation and movement of the arms and hands, with one on each side. Its five roots come from the spaces between the fifth through eighth cervical vertebrae and the first thoracic vertebra. From there, they form a larger structure, then divide, re-combine, and divide again to form smaller nerves and nerve structures as they travel down the armpit. Through the neck and chest, the nerves eventually join and form three cords that include:

  • Lateral cord
  • Medial cord
  • Posterior cord

The posterior cord produces major and minor branches that include:

  • Axillary nerve
  • Radial nerve

The minor branches include:

  • Superior subscapular nerve
  • Inferior subscapular nerve
  • Thoracodorsal nerve

Structure and Position

  • The thoracodorsal nerve branches off the posterior cord in the armpit and travels down, following the subscapular artery, to the latissimus dorsi muscle.
  • It connects to the upper arm, stretches across the back of the armpit, forming the axillary arch, and then expands into a large triangle that wraps around the ribs and the back.
  • The thoracodorsal nerve lies deep in the latissimus dorsi, and the lower edge typically reaches close to the waist.

Variations

  • There is a standard location and course of the thoracodorsal nerve, but individual nerves are not the same in everyone.
  • The nerve typically branches off the posterior cord of the brachial plexus from three different points.
  •  However, different subtypes have been identified.
  • The thoracodorsal nerve supplies the teres major muscle in about 13% of individuals. (Brianna Chu, Bruno Bordoni. 2023)
  • The lats can have a rare anatomical variation known as a Langer’s arch, which is an extra part that connects to muscles or connective tissue of the upper arm beneath the common connecting point.
  • In individuals with this abnormality, the thoracodorsal nerve supplies function/innervation) to the arch. (Ahmed M. Al Maksoud et al., 2015)

Function

The latissimus dorsi muscle cannot function without the thoracodorsal nerve. The muscle and nerve help:

  • Stabilize the back.
  • Pull the body weight up when climbing, swimming, or doing pull-ups.
  • Assist with breathing by expanding the rib cage during inhalation and contracting when exhaling. (Encyclopaedia Britannica. 2023)
  • Rotate the arm inward.
  • Pull the arm toward the center of the body.
  • Extend the shoulders by working with the teres major, teres minor, and posterior deltoid muscles.
  • Bring down the shoulder girdle by arching the spine.
  • To bend to the side by arching the spine.
  • Tilt the pelvis forward.

Conditions

The thoracodorsal nerve can be injured anywhere along its path by trauma or disease. Symptoms of nerve damage can include: (U.S. National Library of Medicine: MedlinePlus. 2022)

  • Pain that can be shooting, stabbing, or electrical sensations.
  • Numbness, tingling.
  • Weakness and loss of function in the associated muscles and body parts, including wrist and finger drop.
  • Because of the nerve’s path through the armpit, doctors have to be cautious of the anatomical variants so they don’t inadvertently damage a nerve during breast cancer procedures, including axillary dissection.
  • The procedure is performed to examine or remove lymph nodes and is used in staging breast cancer and in treatment.
  • According to a study, 11% of individuals with axillary lymph node dissection suffered damage to the nerve. (Roser Belmonte et al., 2015)

Breast Reconstruction

  • In breast reconstruction surgery, the lats can be used as a flap over the implant.
  • Depending on the circumstances, the thoracodorsal nerve can be left intact or severed.
  • The medical community has not agreed on which method has the best outcomes. (Sung-Tack Kwon et al., 2011)
  • There is some evidence that leaving the nerve intact can cause the muscle to contract and dislocate the implant.
  • An intact thoracodorsal nerve may also cause atrophy of the muscle, which can lead to shoulder and arm weakness.

Graft Uses

A portion of the thoracodorsal nerve is commonly used in nerve graft reconstruction to restore function after injury, which includes the following:

  • Musculocutaneous nerve
  • Accessory nerve
  • Axillary nerve
  • The nerve can also be used to restore nerve function to the triceps muscle in the arm.

Rehabilitation

If the thoracodorsal nerve is injured or damaged, treatments can include:

  • Braces or splints.
  • Physical therapy to improve range of motion, flexibility, and muscle strength.
  • If there is compression, surgery may be required to alleviate the pressure.

Exploring Integrative Medicine


References

Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Nerves. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK539761/

Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). Langer’s arch: a rare anomaly affects axillary lymphadenectomy. Journal of surgical case reports, 2015(12), rjv159. doi.org/10.1093/jscr/rjv159

Britannica, The Editors of Encyclopaedia. “latissimus dorsi“. Encyclopedia Britannica, 30 Nov. 2023, www.britannica.com/science/latissimus-dorsi. Accessed 2 January 2024.

U.S. National Library of Medicine: MedlinePlus. Peripheral neuropathy.

Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Long thoracic nerve injury in breast cancer patients treated with axillary lymph node dissection. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 23(1), 169–175. doi.org/10.1007/s00520-014-2338-5

Kwon, S. T., Chang, H., & Oh, M. (2011). Anatomic basis of interfascicular nerve splitting of innervated partial latissimus dorsi muscle flap. Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 64(5), e109–e114. doi.org/10.1016/j.bjps.2010.12.008

Middle Back Trigger Points: El Paso Back Clinic

Middle Back Trigger Points: El Paso Back Clinic

Upper and middle/mid-back pain and/or pain between the shoulder blades is common for individuals who spend long hours sitting or standing. Stress, tension, and repetitive movements can cause middle-back trigger points to develop. Symptoms occur anywhere from the neck’s base to the bottom of the rib cage. Trigger point development and reoccurrence can contribute to chronic upper and middle back pain. Injury Medical Chiropractic and Functional Medicine Clinic can release, relieve and help prevent trigger points through various therapies and treatment plans.

Middle Back Trigger Points: EP's Chiropractic Injury Specialists

Middle Back Trigger Points

The ribs attach to the sternum and adhere to and wrap around the back. Pain and sensation symptoms can radiate to other places where the nerve travels if a nerve in this area is pinched, irritated, or injured. The muscle groups of the chest region also have a significant role in middle back trigger point development. Tension in the chest muscles can overload the muscles of the mid-back region, causing tightness. This happens to individuals that release the trigger points in the mid-back muscles but fail to address the trigger points in the chest muscles, causing reactivation that could worsen the injury. Three muscle groups can cause trigger point referred pain between the shoulder blades include:

  • Rhomboids
  • Middle Trapezius
  • Pectoralis Major

Rhomboid Trigger Points Between the Shoulder Blades

  • The Rhomboid muscle group is found in the mid-back region, between the shoulder blades.
  • These muscles attach along the spine and run diagonally downward to connect to the inside of the shoulder blade.
  • The contraction causes the shoulder blades to retract and rotate.
  • Trigger points only cause pain in the region of the muscle group.
  • They can cause tenderness in the region and the spinous process or the bony tip extending from the lamina or part that can be felt when touching the back.
  • The pain is often described as burning.

Rhomboid Trigger Symptoms

  • A common symptom is superficial aching between the shoulder blades that individuals try to rub with their fingers to get relief.
  • Intense pain can extend upward to the shoulder area above the blade and into the neck area.
  • Individuals may hear or feel a crunching and snapping as they move the shoulder blades.
  • The common rounded-shoulder and forward-head hunching posture are nearly always present in individuals with these trigger points.

Middle Trapezius Trigger Points

  • The trapezius is the large, diamond-shaped muscle group that forms the base of the neck and upper back.
  • It has attachment points at the bottom of the skull, along the spine, collarbone, and shoulder blade.
  • When this muscle contracts, it moves the shoulder blade.
  • Movements can also affect the neck and head region.
  • Trigger points in the middle portion of this muscle refer to pain between the shoulder blades and the spine.
  • Trigger points develop for several reasons, including unhealthy postures, stress, injuries, falls, and sleeping positions.
  • Additionally, tension and added trigger points in the chest muscles can overload the Trapezius muscle fibers, causing trigger point development.

Trapezius Symptoms

  • It can be difficult to distinguish pain from the middle trapezius and rhomboid trigger points.
  • Pain in the middle trapezius can have more of a burning sensation and often extends over the thoracic spine.
  • The pain referral to the spine can activate secondary trigger points in the surrounding muscles.

Pectoralis Major Trigger Points

  • The Pectoralis Major muscle group is the large, flat muscles in the upper chest region.
  • The muscle has four overlapping sections that attach to the ribs, collarbone, chest bone, and upper arm at the shoulder.
  • The muscle group contracts when pushing with the arms in front of the body and rotating the arms inward towards the trunk.
  • Trigger points can radiate pain symptoms to the chest, shoulder, and breast regions.
  • Numbness and/or pain can radiate down the inside of the arm and into the fingers.
  • Trigger points in this muscle group can activate triggers in the upper back, causing pain symptoms between the shoulder blades.

Pectoralis Major Symptoms

  • Individuals will present with chest pain, front shoulder pain, and pain traveling down the inside of the arm to the elbow.
  • If referred pain occurs on the person’s left side, it can be similar to cardiac pain.
  • Consult a cardiologist to rule out cardiac involvement before investigating trigger points.
  • The pain will initially occur on one side of the chest but can spread to the other as it intensifies.
  • In many, the pain is only experienced with the movement of the arms and goes away or decreases with rest.
  • Simultaneous pain in the mid-back, between the shoulder blades, frequently occurs.
  • In women, there may be nipple sensitivity and pain in the breast.
  • The breast can become enlarged from the tension causing impaired lymphatic drainage.

Chiropractic Treatment

Chiropractors treat myofascial pain syndromes such as myofascial trigger points or adhesions with various therapies. A chiropractor will locate trigger points by pressing muscle tissue or manipulating the muscle fibers. Once the trigger points have been found, treatment can include:

  • Massage.
  • Percussive Massage.
  • MET techniques.
  • Myofascial release techniques.
  • Applied pressure to reduce pain gradually.
  • Direct pressure upon the trigger point.
  • Chiropractic adjustments.
  • Targeted stretching.
  • Decompression.
  • Health coaching.

Fighting Inflammation Naturally


References

Barbero, Marco, et al. “Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain.” Current Opinion in Supportive and palliative care vol. 13,3 (2019): 270-276. doi:10.1097/SPC.0000000000000445

Bethers, Amber H et al. “Positional release therapy and therapeutic massage reduce muscle trigger and tender points.” Journal of Bodywork and movement therapies vol. 28 (2021): 264-270. doi:10.1016/j.jbmt.2021.07.005

Birinci, Tansu, et al. “Stretching exercises combined with ischemic compression in pectoralis minor muscle with latent trigger points: A single-blind, randomized, controlled pilot trial.” Complementary therapies in clinical practice vol. 38 (2020): 101080. doi:10.1016/j.ctcp.2019.101080

Farrell C, Kiel J. Anatomy, Back, Rhomboid Muscles. [Updated 2023 May 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK534856/

Gupta, Lokesh, and Shri Prakash Singh. “Ultrasound-Guided Trigger Point Injection for Myofascial Trigger Points in the Subscapularis and Pectoralis Muscles.” Yonsei medical journal vol. 57,2 (2016): 538. doi:10.3349/ymj.2016.57.2.538

Moraska, Albert F et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo-Controlled Trial.” American Journal of physical medicine & Rehabilitation vol. 96,9 (2017): 639-645. doi:10.1097/PHM.0000000000000728

Sadria, Golnaz, et al. “A comparison of the effect of the active release and muscle energy techniques on the latent trigger points of the upper trapezius.” Journal of bodywork and movement therapies vol. 21,4 (2017): 920-925. doi:10.1016/j.jbmt.2016.10.005

Tiric-Campara, Merita, et al. “Occupational overuse syndrome (technological diseases): carpal tunnel syndrome, a mouse shoulder, cervical pain syndrome.” Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH vol. 22,5 (2014): 333-40. doi:10.5455/aim.2014.22.333-340

Thoracic Herniated Disc Chiropractic Back Clinic

Thoracic Herniated Disc Chiropractic Back Clinic

Middle back pain is usually caused by unhealthy posture, improper lifting or twisting, and minor injuries like muscle strains, sprains, and herniated discs. Thoracic herniated discs are less common than neck or low back herniations because of the thoracic vertebrae’s size and rigidity, but they do happen. Chiropractic care can treat thoracic herniated discs and prevent future episodes.Thoracic Herniated Disc Chiropractor

Thoracic Herniated Disc

The 12 thoracic vertebrae between the neck and the lumbar spine make up the largest and least flexible area. The rib cage adds:

  • Protection
  • Support
  • Stabilization of the spine

Symptoms

Herniated discs happen when the soft, gel-like layer of the shock-absorbing intervertebral disc bulges into or leaks through the disc’s tough outer layer. Due to the location, a herniated disc can cause various issues to the middle back, chest wall, and/or abdominal areas around the injured vertebrae. This displacement can cause:

  • Inflammation
  • Compression to the spinal nerves or spinal cord
  • Tingling
  • Numbness
  • Pain
  • Weakness
  • If the lower thoracic region is herniated, symptoms can radiate to one or both lower extremities.

Radiculopathy

If the herniation compresses a thoracic spinal nerve, it can cause radiculopathy or pain that radiates down the nerve and out from the spine into the surrounding muscles. The symptoms can present around the rib cage or upper abdominal area. A large disc herniation can compress the spinal cord inside the spinal canal. This is a condition called myelopathy which can cause:

  • Numbness
  • Tingling
  • Weakness in one or both lower extremities
  • Sometimes bowel and bladder dysfunction
  • In severe cases, paralysis

Causes

Degenerative disc disease and trauma like vehicle collisions or falls are the most common causes of thoracic herniation.

  • Individuals between 30 and 50 are more likely to be affected.
  • As the body ages, the disc’s soft inner layer loses hydration, making it less effective as a shock absorber.
  • The tough outer layer loses elasticity, increasing the risk of disc tears.

Chiropractic Care

  • A chiropractor or neurologic physical therapist can personalize a herniated disc exercise treatment plan to reduce pain, improve strength and posture, and increase mobility.
  • Therapeutic massage can be useful in managing pain and decreasing inflammation.
  • Traction therapy
  • Spinal epidural injections can be used with physical therapy to help manage pain and allow the body to heal independently.

Recommendations

  • Avoid bending, lifting, reaching, and twisting.
  • Apply an ice pack or cold compress for 15- to 20-minute intervals every two hours.
  • Sit in chairs with a firm back to support the spine.
  • When sleeping, place a small pillow under the head and knees to keep the spine in a neutral position to prevent pressure on the herniated region.
  • Avoid too much rest, which can worsen the injury.
  • Gentle physical activity will maintain circulation and keep the muscles strong.

Surgery

Most cases of thoracic herniation do not require surgery. Surgery could be recommended if there is intolerable pain, neurological issues, and conservative treatments are not working. A spine specialist can determine if surgery is necessary based on the injury’s size, type, and location. Spinal surgery will remove all or part of the herniated disc compressing a nerve root. Common surgical procedures include:


Herniated Disc Rehabilitation


References

Barrow Neurological Institute. “Herniated Thoracic Disc.” Barrow Neurological Institute, August 3, 2022. www.barrowneuro.org/condition/thoracic-disc-herniation/.

Court, C., E. Mansour, and C. Bouthors. “Thoracic Disc Herniation: Surgical Treatment.” Orthopaedics & Traumatology: Surgery & Research 104, no. 1 (2018). doi.org/10.1016/j.otsr.2017.04.022.

Dydyk, Alexander M, Ruben Ngnitewe Massa, and Fassil B Mesfin. “Disc Herniation – Statpearls – NCBI Bookshelf.” National Library of Medicine, January 18, 2022. www.ncbi.nlm.nih.gov/books/NBK441822/.

Yoon, Wai Weng, and Jonathan Koch. “Herniated Discs: When Is Surgery Necessary?” EFORT Open Reviews 6, no. 6 (2021): 526–30. doi.org/10.1302/2058-5241.6.210020.

Ear Problems: Back Connection Chiropractor

Ear Problems: Back Connection Chiropractor

Ear problems like blockages or congestion can cause irritation and pain, as well as symptoms such as dizziness, ear discomfort, headaches, and sinus pain that can lead to infection. This condition can happen to anyone but is prevalent in children, individuals that live in high altitudes, and individuals who suffer from allergies. Spinal misalignments can cause interference to the nervous system that can create problems elsewhere in the body, like the ears.

Ear Problems: Spine Connection Chiropractor

If there is neck misalignment along with pinched, tangled nerve/s signal transmissions can misfire or cut off messages disrupting the process of draining the Eustachian tube. This creates a buildup of bacteria and fluid, which can cause pain and pressure. Chiropractic decompression treatment uses gentle manipulation of the cervical spine to release the pressure affecting the ear.

Ear Problems

Bacteria or viruses cause ear infections in the middle ear. Infection often results from another illness like cold, sore throat, flu, respiratory disease, or allergies that causes congestion and swelling of the nasal passages, throat, and eustachian tubes.

Eustachian Tubes

The tubes functions include:

  • Regulating air pressure in the middle ear
  • Resupply fresh air in the ear
  • Drain the middle ear

The eustachian tubes are two canals that connect the middle ear to the throat and nasal cavity, known as the nasopharynx. (The eustachian tubes are more narrow in children, which makes them difficult to drain and more likely to get clogged.)When the lining of these canals comes under stress, they can become inflamed/swollen, blocking or filling with fluid causing excessive pressure and pain. This fluid can become infected and cause ear infection symptoms.

If the ear problem is connected to a misalignment of the cervical spine, the following symptoms may be experienced:

  • Loss of hearing
  • Tinnitus
  • Vertigo
  • Aural fullness is the feeling of a plugged or full ear
  • Balance issues
  • Coordination issues
  • Frequent headaches
  • Nausea
  • Vomiting
  • Frequent episodes that result in vertigo and ringing in the ears could indicate Meniere’s disease, which affects balance and inner ear function.

Middle Ear Infections

Middle ear infection types include:

Acute otitis media

  • This type of infection happens suddenly.
  • It causes swelling and redness.
  • Fluid and pus become trapped under the eardrum/tympanic membrane.
  • Fever and ear pain can manifest.

Chronic otitis media

  • This type happens frequently or does not go away and can take months to years.
  • This type is usually not painful.
  • The ear canal may have liquid coming out.
  • It can be accompanied by a hole that forms in the eardrum and hearing loss.

Otitis media with effusion

  • Also called serous otitis media.
  • Fluid or effusion and mucus build up in the middle ear after an infection passes.
  • It can feel like the ear is full.
  • This can go on for months.
  • It can affect hearing.

Chronic otitis media with effusion

  • Fluid/effusion stays in the middle ear for an extended time.
  • It can build up over and over, despite no infection.
  • It can also affect hearing.

Misalignment in the upper cervical spine can cause muscles to flex awkwardly/irregularly, disrupting the opening and closing of the eustachian tubes and their positioning. This often causes inflammation along the eustachian canal, upper throat, and nasal cavity. If left untreated, the inflammation can develop into an infection, causing swelling and/or fluid buildup in the inner and middle ear. Common symptoms of middle ear infections in adults include:

  • Pain in one or both ears
  • Hearing is muffled
  • Sore throat
  • Fluid drainage from the ear

Chiropractic Realignment

Treatments are helpful for individuals who want to reduce taking antibiotics, which can minimize immunity by destroying the healthy bacteria in the gut. Chiropractic is a simple and effective way to treat ear problems. Realigning the vertebrae relieves tissue inflammation/swelling around the Eustachian tube to allow drainage, relieve pressure, and restore health.


Spinal Decompression Chiropractor


References

Collins, Rachael, et al. “Paralysis from an ear infection: a severe case of otitis externa leading to acute complete cervical cord syndrome.” BMJ case reports vol. 14,12 e245594. 1 Dec. 2021, doi:10.1136/bcr-2021-245594

Harmes, Kathryn M et al. “Otitis media: diagnosis and treatment.” American family physician vol. 88,7 (2013): 435-40.

Laulajainen Hongisto, Anu et al. “Severe Acute Otitis Media and Acute Mastoiditis in Adults.” The journal of international advanced otology vol. 12,3 (2016): 224-230. doi:10.5152/iao.2016.2620

Murphy, D R. “Chiropractic rehabilitation of the cervical spine.” Journal of manipulative and physiological therapeutics vol. 23,6 (2000): 404-8. doi:10.1067/mmt.2000.108143

Polkinghorn, B S. “Treatment of cervical disc protrusions via instrumental chiropractic adjustment.” Journal of manipulative and physiological therapeutics vol. 21,2 (1998): 114-21.

Body Flexibleness: Decompression

Body Flexibleness: Decompression

Body Flexibleness: The body loses a small amount of flexibility during normal aging. Decreased body flexibility can negatively impact everyday life by preventing normal function. If the muscles are not taken through their full range of motion to maintain length, strength is lost, and decreased flexibility increases. This can happen from:

  • Water loss in the tissues and spine.
  • Increased stiffness in the joints.
  • Loss of elasticity throughout the muscle tendons and surrounding tissues.

Body Flexibleness: Decompression

Body Flexibleness

Individuals of all ages struggle with flexibility, but there is a difference in age stiffness. However, a sedentary lifestyle can make everyday activities feel more strenuous than before. Less flexibleness can also cause pain. For example, if the muscles in the front of the legs become tight, it can limit movement in the pelvis and hips, leading to low back pain.

Several problems can result from decreased flexibility, including:

  • Shorter steps while walking.
  • Slower walking speed.
  • Back pain.
  • Increased risk of falls.

Flexibleness improves overall movement and helps prevent simple strains and injuries, including:

  • Back injury.
  • Muscle strains.
  • Shoulder injury.
  • Hip injury.
  • Leg injury.

A stretching program for the hip muscles can improve walking speed and step length. This will result in improved walking function with improved and increased control, decreasing the risk of injury. Step length is also critical in preventing injuries. More distance while walking and longer steps mean better balance, making it essential to maintain flexibility in the leg muscles.

Chiropractic Decompression

Routine chiropractic adjustments and spinal decompression can slow the progression of joint degeneration, improve movement, and decrease the risk of injury. When the vertebrae are properly aligned, the entire body operates at its optimal level. There is proper lubrication of joints and muscles, improving mobility and function and removing stress on the nerves, muscles, ligaments, and tendons. Chiropractic treats the joints, bones, and muscles to improve body flexibleness through manual and motorized decompression, adjustments, and massage, combined with health coaching, nutrition, stretching, and exercises to do at home.


DRX Spinal Decompression


References

“American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults.” Medicine and science in sports and exercise vol. 30,6 (1998): 975-91. doi:10.1097/00005768-199806000-00032

Choi, Jioun, et al. “Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation.” Journal of physical therapy science vol. 27,2 (2015): 481-3. doi:10.1589/jpts.27.481

Giraud, Karine et al. “Raideur matinale” [Morning stiffness]. Presse medicale (Paris, France : 1983) vol. 33,12 Pt 1 (2004): 803-7; discussion 825. doi:10.1016/s0755-4982(04)98750-7

Tseng, Shiuan-Yu, et al. “Effect of Two Frequencies of Whole-Body Vibration Training on Balance and Flexibility of the Elderly: A Randomized Controlled Trial.” American journal of physical medicine & rehabilitation vol. 95,10 (2016): 730-7. doi:10.1097/PHM.0000000000000477

Thoracic Back Pain

Thoracic Back Pain

The thoracic spine, also known as the upper or middle back, is designed for stability to anchor the rib cage and protect the organs in the chest. It is highly resistant to injury and pain. However, when thoracic back pain does present, it is usually from long-term posture problems or an injury. Thoracic back pain is less common than lower back and neck pain, but it does affect up to 20% of the population, particularly women. Treatment options include chiropractic for quick and long-term pain relief.

Thoracic Back Pain

Thoracic Back Pain and Soreness

The thoracic area is vital for various functions related to:

Common reasons for experiencing thoracic back pain include:

  • A direct hit or high-impact injury from a fall.
  • Sports injury.
  • Automobile accident.
  • Unhealthy postures that put the spine in chronic misalignment, causing strain.
  • Repetitive overuse injury from bending, reaching, lifting, twisting.
  • Poor core or shoulder mechanics, causing muscle imbalance.
  • Muscular irritation, the large upper back muscles are prone to developing strains or tightness that can be painful and difficult to alleviate.
  • De-conditioning or lack of strength.
  • Joint dysfunction can come from a sudden injury or natural degeneration from aging. Examples include facet joint cartilage tear or joint capsule tear.

Upper back pain usually feels like a sharp, burning pain localized to one spot or a general achiness that can flare up and spread out to the shoulder, neck, and arms.

Types of Upper Back Pain

These include:

  • Myofascial pain
  • Spine degeneration
  • Joint dysfunction
  • Nerve dysfunction
  • General spinal misalignments

Depending on what specific tissues are affected, pain can occur with breathing or arm use. It is recommended to have a healthcare professional perform an examination and get an accurate diagnosis. A chiropractor understands the delicate balance and functions that the thoracic spine provides and can develop a proper treatment plan.

Chiropractic

Treatment options will depend on the symptoms, underlying dysfunctions, and individual preferences. ​Recommendations for treatment often include:

  • Spine adjustments to improve alignment and nerve integrity.
  • Posture training to maintain spinal alignment.
  • Therapeutic massage.
  • Exercise training to restore muscular balance.
  • Non-invasive pain-relieving techniques.
  • Health coaching.

Body Composition


Plant-Based Diets for Weight Loss

Individuals who follow vegan, vegetarian, and semivegetarian diets have reported and shown they are less likely to be overweight or obese. This can indicate that reducing intake of meat and animal products is beneficial for weight loss. Studies have found that individuals who follow a vegan diet may lose more weight than individuals on a more conventional weight loss diet, even with similar calories consumed, and often have significant improvements in blood sugar and inflammation markers.

Plant-Based Protein and Muscle Gain

Some plant-based proteins are just as effective as animal protein at promoting muscle gain. A study found that supplementing rice protein following resistance training had similar benefits to whey protein supplementation. Both groups had:

References

Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009;10:77.

Cichoń, Dorota et al. “Efficacy of Physiotherapy in Reducing Back Pain and Improve Joint Mobility in Older Women.” Ortopedia, traumatologia, rehabilitacja vol. 21,1 (2019): 45-55. doi:10.5604/01.3001.0013.1115

Fouquet N, Bodin J, Descatha A, et al. Prevalence of thoracic spine pain in a surveillance network. Occup Med (Lond). 2015;65(2):122-5.

Jäger, Ralf et al. “Comparison of rice and whey protein isolate digestion rate and amino acid absorption.” Journal of the International Society of Sports Nutrition vol. 10,Suppl 1 P12. 6 Dec. 2013, doi:10.1186/1550-2783-10-S1-P12

Joy, Jordan M et al. “The effects of 8 weeks of whey or rice protein supplementation on body composition and exercise performance.” Nutrition journal vol. 12 86. 20 Jun. 2013, doi:10.1186/1475-2891-12-86

Medawar, Evelyn et al. “The effects of plant-based diets on the body and the brain: a systematic review.” Translational psychiatry vol. 9,1 226. 12 Sep. 2019, doi:10.1038/s41398-019-0552-0

Newby, PK et al. “Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women.” The American journal of clinical nutrition vol. 81,6 (2005): 1267-74. doi:10.1093/ajcn/81.6.1267

Pope, Malcolm H et al. “Spine ergonomics.” Annual review of biomedical engineering vol. 4 (2002): 49-68. doi:10.1146/annurev.bioeng.4.092101.122107

Thoracic Upper Back Pain

Thoracic Upper Back Pain

The thoracic upper back or middle back is designed for stability to anchor the rib cage and protect the organs within the chest. Compared to the neck and lower back, the upper back is highly resistant to injury and pain. When thoracic upper back pain does present, it is usually brought on from long-term poor posture or an injury that overwhelms the sturdiness. It is less common than lower back and neck pain, but it does affect around 20% of the population and primarily women. It can occur for a variety of reasons, and chiropractic treatment can bring long-term relief.

Thoracic Upper Back Pain

Thoracic Upper Back Pain

The thoracic upper back is crucial for various functions related to:

  • Neural tissue health
  • Organ protection
  • Arm function
  • Breathing mechanics
  • Trunk support

The delicate balance and function can create potential issues and imbalances, causing soreness, strain, and pain. Underlying causes for thoracic upper back pain include:

  • Direct impact on the area.
  • Injury from a fall, sports, or automobile accident.
  • Unhealthy posturing/positions that place added strain on the spine, causing misalignment.
  • Repetitive motions and overuse like pulling, pushing, reaching, and twisting.
  • Repetitive/Improper shoulder mechanics can lead to muscle imbalance and poor movement.
  • Poor core mechanics.
  • Nerve dysfunction.

Muscular irritation

  • Muscular irritation usually comes from unconditioned muscles and a lack of strength.
  • The shoulder attaches large muscles to the shoulder blade and the back of the rib cage.
  • These are large muscles and are prone to developing strains or tightness.

Joint dysfunction

  • Caused by a sudden injury.
  • Natural spinal degeneration from aging.
  • Facet joint cartilage and/or joint capsule tearing.

Chiropractic

Chiropractic can realign the spine and body if experiencing any of the following:

  • Symptoms that keep returning even with the use of medication.
  • Home remedies do not bring adequate relief.
  • Unable to prevent symptoms from presenting.
  • Chronic pain.

Injury Medical Chiropractic and Functional Medicine Clinic will develop a personalized/customized treatment plan specific to the individual’s needs. Treatment will include:

  • Spinal adjustments to improve alignment and nerve integrity.
  • Therapeutic massage.
  • Posture training to increase spinal alignment.
  • Exercise training to restore muscular balance.
  • Health coaching.
  • Anti-Inflammatory Diet.

Body Composition


Sitting For Prolonged Periods

Weakened Muscles

Metabolism is linked with body composition, meaning that increased muscle increases metabolism helping to burn more calories.

  • When sitting, the gluteal muscles, abdominal muscles, and legs become inactive.
  • Sitting for extended periods day after day can cause these muscles to degenerate.
  • Consistent muscle loss from the lower body can hurt the body’s functional strength and, with age, increase the risk of injury.
  • Any muscle loss, especially from the lower body, and is the largest muscle group, can lead to consistent fat gain.

Circulation Slows Down

Sitting for too long also slows down blood flow to the brain and the legs, causing them to become sluggish.

  • Sitting without standing can increase the risk of developing blood clots.
  • Blood clots can break off and cause blockages throughout the body.
  • One study showed a significant reduction in the vascular flow after sitting for just three hours.
  • But individuals who took breaks and got up to walk around for two minutes every hour showed improved circulation.
References

Beddhu, Srinivasan et al. “Light-intensity physical activities and mortality in the United States general population and CKD subpopulation.” Clinical journal of the American Society of Nephrology: CJASN vol. 10,7 (2015): 1145-53. doi:10.2215/CJN.08410814

Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009;10:77.

Fouquet N, Bodin J, Descatha A, et al. Prevalence of thoracic spine pain in a surveillance network. Occup Med (Lond). 2015;65(2):122-5.

McManus, Ali M et al. “Impact of prolonged sitting on vascular function in young girls.” Experimental physiology vol. 100,11 (2015): 1379-87. doi:10.1113/EP085355