Thoracic Spine

Thoracic Spine

The anatomy of the thoracic spine differs from the cervical and lumbar spine in the addition of the ribcage. There is a rib attached to each side of the thoracic spine, in multiple locations – the head of the rib articulates with not only its corresponding vertebra, but also the superior portion of the rib head also articulates with the inferior aspect of the vertebra above. 

Your costo-vertebral joints can be a common source of pain in the thoracic spine, as there is a mirriad of connective tissue, and mobile joints in a small space. An injury to a costo-vertebral joint is commonly referred to as a costo-vertebral joint dysfunction, this is due to the injury occurring through a complicated combination of movements. 

While the degree of movement at each of these joints is actually quite minimum, the amount of times each of these joints move everyday is quite high. Everytime you take a breath, the joints are forced to move in a “bucket-handle” pattern up and down around a fixed location. This movement allows for the expansion of the lungs, and entry of air into them. 

A costo-vertebral joint dysfunction occurs when there is significant enough load through the region to irritate, damage, or disturb the connective tissue. This load comes in one of two formats, strong and sudden – think car accident, or weak and prolonged – think strange sleeping position. Some of the other more common causes of a costo-vertebral joint irritation are; repetitive movements/lifting, lifting a heavy load with poor technique, or a muscle imbalance surrounding the spine. 

Generally speaking costo-vertebral injuries occur very quickly, resulting in sudden, sharp pain, that may take your breath away. In the hours following the initial injury, muscle spasm will begin to set in, with the peak generally being after some prolonged rest. This is why the day after the initial joint sprain and subsequent dysfunction will result in loss of mobility the next day.

Symptoms may include; 

  • Decreased range of motion through the thoracic spine
  • inability to stand upright
  • Increased pain on a cough/sneeze
  • Increased pain/sensation on deep breath
  • General tightness throughout the chest, or around one rib in particular

Physiotherapy is generally considered the best course of action for costo-vertebral joint sprains and irritations. During your Physiotherapy consultation you will be treated with a variety of modalities, including manual therapy, and soft/deep tissue release. Along with this your Physiotherapist will be able to provide you with some advice and education around ways to prevent re-aggravation and re-injury in the future.