Case Study: Anterior Subluxation of the Thoracic Spine

134914810_e841b66805_bA 40-year old female patient, Jill, was referred to me complaining of mid-back pain. She remembers that her mid-back was subjected to increasing pain after doing handstand push-ups, overhead presses, and snatch lifts. The quality of her pain was sharp and stabbing.

Although non-radiating, it was coupled with difficulty breathing. After hearing this description, I was able to diagnose her as having an anterior subluxation of the thoracic vertebra. Deep upper back pain is rarely serious but frequently, it can be extremely irritating.

To give you a clearer picture, let me describe the anatomy of thoracic cavity. There are twelve thoracic vertebrae, and each bilaterally hinges on three joints to a rib for a total of six. They are then anteriorly connected to the breastbone in the front. The mid-back stretches from the base of the neck to the bottom of the ribcage, totaling about a hundred joint connections. Simply put, this means that each thoracic vertebra has twelve joints associated with it:

  • Two facets with the vertebrae above and below
  • One disc
  • Six costovertebral joints between the vertebra and the two ribs

Now, that’s a handful of joints on the thoracic vertebral region, each with supporting ligaments and muscles, making it a super complex area with pain as its constant unwelcome visitor. On the contrary, the mid-back is a far stronger fortress than its neighbors, the neck and the lumbar spine, due to the stabilizing effect of the rib cage. However, this seemingly stable region is not immune from the onslaught of pain brought about by a good sneeze, particularly if twisting at the time, or a bout of bronchitis.  This may still subluxate or sprain one of those joints causing inconceivable pain. Each breath taken is akin to a virtual stab in the back with a crusty, jagged knife riddled with rust. The theory is that nerve transmission is disrupted and causes pain in the back, as well as other areas of the body.

The treatment is relatively simple. Individuals who possess a foam roller may attempt to relieve the pain and discomfort by rolling on the floor several times. It is only when the pain persists that professional treatment may need to be sought to realign the vertebra. Ultimately, the goal of chiropractic treatment is not only geared towards the relief of the present ailment but also to prevent its recurrence. A careful calculation of risks versus benefits is always of paramount importance before employing any suggested intervention.