Thoracic (mid-back) & Rib Pain
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The mid-back, or thorax, gets a bit abused by modern life.
When we sit down (which, unfortunately, most of us do a fair bit), by bringing our knees up to the height of our hips, we flatten (or worse, slump) our low backs. This then increases the thoracic kyphosis, or rounds over the mid back. The muscles whose job it is to support us are then stretched over the increased curve of the mid-back. The shoulders fall forwards, further tautening the tissues around the scapulae (shoulder blades) and upper back. This postural pattern also compresses the front of the rib cage, making breathing less efficient. You breathe on average 22,000 times a day; so anything making you use more energy than you have to, is likely to have consequences. |
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Image from OpenStax CNX
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Breathing is pretty important. Not only is it how we get that sweet, sweet oxygen we need to stay alive, and get rid of buildup of carbon dioxide, the movement of the diaphragm (the big dome-shaped muscle that sits between the thorax, or chest, and abdomen, or belly) helps to drive a lot of the movement of fluids around the body. You can see on the left that the body has a number of different cavities ('hollows') in it. Pressure differences between these help to squeeze blood and other fluids from one place to another. |
Every time you breathe in, your diaphragm descends, contracting and flattening out.
This makes the thoracic cavity larger suddenly, and lowers the intrathoracic pressure. This makes air rush in through the mouth and nose, to even things up.
At the same time, the diaphragm pushing down squishes the contents of the abdominopelvic cavity, increasing the pressure inside it. As an aside, this is why taking a deep breath (or coughing and sneezing, both activities which increase the intra-abdominal pressure) can make your back pain worse; there is more pressure from the inside.
This combination, of more pressure in the abdomen and less in the chest, helps to drive blood returning from the legs back up to the heart.
So efficient, effective breathing does more than just keep us supplied with oxygen and eliminate wastes. Your osteopath can help identify inefficient breathing habits and help you improve the mechanics of respiration.
This makes the thoracic cavity larger suddenly, and lowers the intrathoracic pressure. This makes air rush in through the mouth and nose, to even things up.
At the same time, the diaphragm pushing down squishes the contents of the abdominopelvic cavity, increasing the pressure inside it. As an aside, this is why taking a deep breath (or coughing and sneezing, both activities which increase the intra-abdominal pressure) can make your back pain worse; there is more pressure from the inside.
This combination, of more pressure in the abdomen and less in the chest, helps to drive blood returning from the legs back up to the heart.
So efficient, effective breathing does more than just keep us supplied with oxygen and eliminate wastes. Your osteopath can help identify inefficient breathing habits and help you improve the mechanics of respiration.
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Ribs can also be a source of pain and discomfort themselves.
The articulations where they join to the vertebrae at the back and the cartilage and sternum (or breastbone) at the front; the nerves that run between them; and the muscles which attach to them are all potential sources of pain and dysfunction. Furthermore, a jammed-up or dysfunctional upper rib, because it is not moving freely and easily with its fellows, tends to 'stick out'. You can feel this quite distinctly just on the inside edge of the shoulder blade; there will be a palpable bony lump at the angle of the rib. This raised bump can irritate the muscles under, and attaching to, the shoulder blade. The body will try and protect these muscles by tensing them, potentially contributing to a slew of problems in and around the upper back, shoulder, and even into the arm. |
Showing the thoracic spine and cage from the back, showing how the ribs attach to the spine, and the nerves that run between them.
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