Thoracic Spine Health and Back Pain

back pain

Back pain is a common complaint we see in our clinic. And while we're well versed in helping you reduce your symptoms with our little magic needles, we know there's a lot people can do to prevent back pain through posture and movement. That's why we enlisted our fitness friend, Hannah Wydeven, to write a series of blog posts about back pain. You can read pt. 1 and pt. 2 of this series as well.

Hannah is the owner of Solcana Fitness in the Seward Neighborhood of Minneapolis (where both Amy and Kim work out AND offered group acupuncture!). Hannah has been a fitness coach since 2010, and works with all types of bodies, specializing in helping womxn and queer folks gain confidence in the gym. You can check out her work at 

In the last installment of this blog, I talked about core bracing, and how proper bracing can support back health. This time, we are going to move up the body a little bit and talk about the thoracic spine. Your thorax is the part of your body between your neck and your abdomen, so your thoracic spine is that mid-to-upper back area around your shoulders. Frequently, people associate back pain with the lumbar or lower spine, but much of those pain problems might actually originate from issues the thoracic spine. Thoracic issues can also lead to shoulder pain, neck stiffness or pain, and a host of other problems throughout the body. 

The thoracic area is the central part of the S-curve of your spine, and has the ability to flex, extend and axially rotate. The thoracic region is also the longest portion of your spine, and the only one attached to the rib cage. As you can imagine, the health of your thoracic spine is going to have a huge impact on the other portions of your back. With 12 vertebrae, the Thoracic spine is the most complicated portion of the spine, and therefore a good place to look if you are dealing with bodily pain. There are two major types of thoracic issues I see daily in the gym that can contribute to back pain issues. 


Thoracic Kyphosis

This is an extreme flexion of the thoracic spine. Kyphosis is actually a technical term for a type of flexion that is beyond the normal range, but it can also be a useful term when we are talking about the way that your t-spine looks when it’s out of normal alignment. In this position, the thoracic spine curvature both puts increased pressure on your lumbar and cervical spine, frequently leading to a lordosis in those areas. This has the effect of creating the “sway back” and “turtleneck” look. This isn’t a cute look, but it’s also problematic because it creates pressure points in the neck and low back that can be particularly painful and even damaged. 


Thoracic kyphosis is often a symptom of desk life, or even spending too much time on your phone or looking down at your laptop. This disadvantaged position can become somewhat permanent when we get up and walk around that way, workout that way and even sleep that way. Folks with this problem find that their shoulders feel super tight, their lower back feel sticky and painful, and they may even have sharp neck pain or numbness in their hands and arms. 

Immobile T-spine

The other major problem I see in folks who come to my gym is immobility in their thoracic spine.  Years of repetitive movement, lack of movement, or even weak back muscles can all contribute to this problem. What is happening with a stiff thoracic spine is that the fascia around the spine and muscles in that area has become brittle and non-pliable, losing its ability to move in a variety of directions. Immobility in the t-spine can be extremely problematic, as it means the other portions of your spine and back will compensate for that lack of flexibility and damage can occur. For example, when a person with a stiff t-spine attempts to carry weight, their lower back will compensate through lordosis, which causes pain and injury, or they will not be able to properly stack weight over their shoulders, causing pain in the shoulder tendons. 


Luckily, the thoracic spine is a relatively responsive part of the body to change. By adding in a few motor control fixes, stretches and stability exercises, we can see a pretty dramatic change in the way our thoracic spine functions. 

Test and retest

Start by trying a cat and cow position, taking a snap of yourself to see how flexible your thoracic spine normally looks. 


Then, try the following simple exercises:

Foam Rolling: The foam roller is a very effective way to break up some of the fascial connections around your vertebrae, and invite some increased pliability in your back. I recommend starting with the foam roller hot-dog style, right below your shoulders. Inhale, lifting your body up, then as you exhale, reach overhead and soften your body around the roller. Try this in several different spots along your thoracic spine. Spend 2-5 minutes here. 

Sit’n’Press: Sit with your entire back up against the wall, feet pressed together. Goal-post your arms against the wall and slowly slide your arms up, keeping everything attached, as far as you can. Try this 10-15 times. 

T-spine Rotations: Lay on your back with knees and feet up, arms out to the side. Keep shoulders on the ground as you slowly rotate your feet and knees toward one side. As soon as you feel your shoulder try to leave the ground, pull your knees and feet back to the midline. Try 10 reps per side. 


After trying these exercises, give your cat-cow a retest and see if you were able to add some more dynamic movement to the thoracic spine. Do you feel more upright? A little more powerful perhaps?

Putting it all together

Lastly, to keep yourself in check when you are walking around or just living on the daily, here is a quick way to get your t-spine in line, that builds on the foundation we have set over the last couple of blog posts. Set your brace (butt lightly squeezed, pelvic floor lifted, squeeze the grape in your belly button, breathe into the diaphragm). Now, while maintaining that brace, extend your thoracic spine by imagining you are trying to broaden your chest. Tuck your chin back a bit to get your cervical spine in place, and voila, you are the master of your spine!

Though the spine seems extremely complicated (soooo many pieces), controlling it is not as difficult as it seems. A little bit of motion and body awareness can go a long way. 

So what if you already have pain? What can you do to deal with it? Next blog post, we will start tackling the spine one piece at a time, talking about ways we can manage pain and improve it over time. Tune in then for more spinal yumminess! 

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*The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.

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