Lila Abbate, PT, DPT, MS, OCS, WCS
How We Treat Pain in the Thoracic Spine and Ribcage
Back pain is commonly associated with the lumbar spine, or lower back, but the thoracic spine can come with its own troubles as well. Running from the midback all the way through the very base of the neck, the thoracic spine is where all of our ribs connect to our vertebrae. Being quite literally the backbone of our rib cage, any dysfunction in this area can affect the ribs and/or the sternum. The lower thoracic region can cause shooting abdominal pain if you have a condition called slipping rib syndrome, and the upper thoracic region can contribute to shoulder pain and referred pain of the upper extremities.
As you can see, the thoracic spine is responsible for holding a lot together in our bodies, but because of the ambiguous nature of pain in our torsos, some forms of thoracic pain go unrecognized and underdiagnosed.  Together with your doctors, highly trained orthopedic specialists like the physical therapists at New Dimensions Physical Therapy will be able to diagnose and treat the various forms of thoracic pain and the referred pain that goes with them. If you’re wondering what to expect during your visits, here are just a few modalities used to treat pain in the thoracic spine and ribcage: 1. Pulsed Ultrasounds. If you are experiencing rib pain as a result of a fracture, pulsed ultrasounds may be helpful in speeding up recovery time. It’s been shown that pulsed ultrasounds can accelerate your return to work and physical activities as opposed to healing without them. 
2. Mobility Exercises. These exercises will be designed by your physical therapist to help bring your joints into a comfortable and normal range of motion. They can be performed with or without referred pain. 
3. Thoracic and Rib Manipulation. Your therapist will use their knowledge of the body’s soft tissues and natural anatomical positions to manipulate your ribs and thoracic vertebrae back into cohesiveness with the rest of your skeleton.  4. Postural Exercises. Postural exercises help strengthen your core muscles that attach to your spine and pelvis. Healthy, strong core muscles will prove helpful for your thoracic pain as well as any referred pain in your arms and shoulders. 
Of course, any modalities used to treat upper back and rib pain should be done under the direction and supervision of one of our specialized physical therapists. Their knowledge and experience could mean the difference between supporting your body’s natural path of healing or exacerbating symptoms by use of improper body mechanics. Call us at (516) 304-5373 to get into the hands of the right professionals for your symptoms. Your health and wellness are our top priority and we hope it’s yours, too!
 Mohamad Y. Fares, Zakia Dimassi, Hasan Baydoun, Umayya Musharrafieh, Slipping Rib Syndrome: Solving the Mystery of the Shooting Pain, The American Journal of the Medical Sciences, Volume 357, Issue 2, 2019, Pages 168-173, ISSN 0002-9629, https://doi.org/10.1016/j.amjms.2018.10.007.  Santana-Rodríguez, N., Clavo, B., Llontop, P., Fiuza, M. D., Calatayud-Gastardi, J., López, D., … Bröering, D. C. (2018). Pulsed Ultrasounds Reduce Pain and Disability, Increasing Rib Fracture Healing, in a Randomized Controlled Trial. Pain Medicine, 20(10), 1980–1988. doi: 10.1093/pm/pny224  Masaracchio, M., Kirker, K., Collins, C. K., Hanney, W., & Liu, X. (2016, December). AN INTERVENTION-BASED CLINICAL REASONING FRAMEWORK TO GUIDE THE MANAGEMENT OF THORACIC PAIN IN A DANCER: A CASE REPORT. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5159637/.