Thoracic Spine / Upper Back Pain

The thoracic spine includes 12 vertebrae that link to your ribcage in order to provide it with stability and protect the organs in the thoracic cavity.

Upper back pain linked to the thoracic spine area can include inflammation of the muscle attachments to the spine, tight muscles in the upper back, or in adolescent male athletes, Scheuermann’s disease that starts with acute pain in the upper back and may develop into a rounded thoracic spine in later years (known as kyphosis).

Resting, stretching properly, and heating any enflamed muscles are the standard treatments for upper back pain.

Herniated Disk

Also called a “slipped” or “ruptured” disk along the spinal column; common for neck, lower back, arm, or leg pain. These disks assist the spine in absorbing shock as well as help with the flexibility of the back.

A herniated disk can result from a number of things as you age. Common causes of a herniated disk include improper methods of lifting objects (using your back instead of legs), repetitive strenuous activities and excess body weight placing pressure on the disks. The disks can grow weaker through activities like smoking as well.

Pain can be centralized in either the lower back or the neck.

  • In the lower back, you may experience weakness in one leg, a feeling of numbness or “pins and needles” in one leg or buttock, a burning pain in the neck, or a loss of bladder/bowel control.
  • In the neck, you will experience the same feelings, but centralized in one arm instead of one leg. Also, the burning sensations will be felt in the arm or shoulder in addition to the neck.

Nonsurgical treatment is effective in 90% of patients. Rest and over-the-counter pain relievers may be all that is necessary to fix the issue. Sometimes, anti-inflammatory or muscle relaxants are helpful as well. Cold compresses placed for no more than 20 minutes at a time may be utilized, as well as gentle heat compresses after any spasms settle. Limit physical activity and sitting for long periods of time. Should these methods fail, regular injections of a cortisone-like drug may be used to lessen nerve irritation and increase physical therapy participation.

Surgical treatment may be required if a significant loss of function is felt by a patient. Depending on the size and location of the herniation, either microdiskectomy or laminectomy will be performed.

Low Back Pain

An extremely common occurrence that usually resolves itself within a few weeks for many people. Sometimes, however, lower back pain can be severe and persistent in nature.

The lower back serves primarily as a power center for the body’s movement. It assists in motions such as turning, bending, twisting, and provides the means for people to stand, walk, and lift. As you may have guessed, a properly functioning lower back is pivotal to daily activity.

Lower back pain has numerous causes, making pinpointing a common cause difficult. Many times, lower back pain is due to the aging of the vertebrae disks. Other times, excessive stress from heavy lifting, arthritis of the spine, problems with the tendons or ligaments around the spine, or malpositioning of the vertebrae may be to blame. Occasionally, there is no cause associated with lower back pain.

There are a multitude of surgical and nonsurgical treatments for severe lower back pain, but a few preventative tips could save you from a lot of pain down the road: exercise regularly, lift objects properly (using the legs instead of the back), maintain a proper body weight, avoid smoking, and keep good posture and refrain from slouching.

Low Back Sprains & Strains

A sprain in the lower back can occur when a sudden forceful movement injures a ligament that had previously grown stiff or weak.

Treatment options include activity modification, anti-inflammatory medications, and a possible rehab program.

Sciatica/Slipped Disc
Should you experience pain in your lower back or hip radiating to the back of your thigh and into your leg, you may be suffering from sciatica. This is when a herniated disk presses on the roots of the sciatic nerve and it is similar to a bad leg cramp lasting for weeks.

Sciatica may result from aging, plus any sudden pressure placed on the disks cushioning your spine. Around 85% of patients get better without surgery; bed rest and anti-inflammatory medicine is recommended for a few days. Motion reduces inflammation, so physical activity is recommended. If pain remains for more than three months, surgery to remove part of the herniated disk may be recommended.

This is a condition where the spinal curves go from side-to-side, unable to be corrected from simply learning to stand up straight. The appearance of the spine may resemble an “S” or “C” shape and in some cases, the spine may have rotated slightly, causing the shoulders or waist to appear uneven.

Most cases in children will remain small and only need periodic checkups with an orthopaedist. Should the curve progress, an orthopaedic brace may be utilized to prevent any further progression. If the brace does not keep the curve under control, surgery may be recommended.


Kyphosis is a postural syndrome based in the upper back and neck. World cyclists and baseball catchers are at the highest risk level for kyphosis, as they have to hold a certain posture for extended periods of time. In kyphosis, there is a muscle imbalance with the pectoral and posterior neck muscles being tight and the muscles of the upper back and deep neck flexors being weak. This may result in exceptionally rounded shoulders and a chin pointing forward.

Kyphosis presents with burning or aching in the upper back and neck, with pain felt during prolonged periods of standing or sitting that eases with movement.

Treatment for kyphosis generally includes some massage therapy and a few strengthening exercises to correct any muscle imbalances.


Lordosis is when the lower back curves inwards more than it should, otherwise known as an exaggerated lumbar curve. This places stress on other parts of the spine, resulting in pain.

This imbalance and exaggeration can be attributed to different muscles around the hip and spine becoming tight while others grow weak and stretched. Muscles that are tight will require stretching exercises and muscles that are weak will require strengthening.

Spinal Fusion

This is a surgical method generally used to correct issues with the vertebrae of the spine. By fusing together two or more vertebrae using bone grafts and metallic rods and screws, the spine can become stabilized. Such a method is generally used to treat spinal vertebrae injuries, unstable spines resulting from infection or tumors, abnormal curvatures of the spine like scoliosis or kyphosis, or a herniated disk. Consult your physician to see if this surgery is right for your situation.


This is an overuse injury where repeated stress to a bone called the pars causes a fracture. Most competitive sports carry a heightened risk for this injury, like gymnastics, dance, soccer, football, and others. Anytime the spine is flexed forward, bent back, or rotated many times, there is a risk for injury.

Treatment for this injury is not universal; doctors are still trying to come to an agreement. Sometimes, wearing a brace and engaging in physical therapy is recommended, other times electrical stimulation, and in some instances, surgery to correct it.

Degenerative Disc Disease

DDD is a pathological process where intervertebral discs become progressively disrupted and begins to fail in its functions. This is due to something as common as a lifting accident which results in the dehydration of a spinal disc.

Treatment can be either surgical, or a combination of physical therapy, chiropractic treatments, or anti-inflammatory medications to provide relief.

Sacroiliac Joint Injury

This joint is located at the bottom of your back, one on either side of your spine and helps make up the rear part of the pelvic girdle. There are twisting forces applied to the pelvic girdle when lower limbs are moved. Sometimes, these forces can cause the sacroiliac joint  to get stuck, or one half of the pelvis will glide forwards or backwards, both resulting in inflammation. This is common, especially after pregnancy.

Pain is centralized either to the left or right of the lower back, ranging from an ache to acute pain restricting movement. Symptoms include having trouble turning over in bed, struggling to put on shoes/socks and pain when getting your legs in and out of the car.

Rest, anti-inflammatory medications, and electrotherapy for affected tissues is standard procedure, but sometimes leveling the pelvis may be necessary.

Coccyx / Tail Bone Pain

Coccyx pain is also called coccygodynia, found more often in females than males. This presents with pain in the tailbone during or after sitting and can be worse when sitting on a soft surface.

This pain can be the result of an unstable coccyx, or a fall/trauma delivered to the base of the spine. Repetitive strain or overuse from sports like cycling or rowing can be a cause, also.

As treatment, stretching, strengthening and massages to the muscles around the coccyx are recommended. Sometimes, a steroid injection is given and in rare instances, the coccyx may be removed through surgery.

Nerve Root Pain

Damage to the nerve root, known as radiculopathy, can be the root of considerable back pain because a nerve root becomes irritated. This is generally caused by a disc herniation or bone spurs due to a degenerated disc.

Radiculopathy presents with pain, numbness, tingling, or weakness down the leg or arm (lumbar or cervical radiculopathy, respectively) due to an irritated nerve root.

Anti-inflammatory medications or corticosteroids may be employed to provide temporary relief.

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