Upper back (Thoracic) Pain – We can help

Pain between your shoulder blades – How we can fix it

Do you suffer with Thoracic pain? I explain the reasons you can suffer with this and how I can help.

Too many of us sit at desks for hours on end leading to a static posture and often using a mouse for hours on end, Thoracic pain is one of the most common presentations of back pain I see. It is not just office workers also, mothers, gym goers old and youngsters.

Referred Pain:
From the neck

Pain can be referred from your neck, this diagram shows the neck vertebrae (C4-7) which is the bottom half of your neck and this is where it can refer to in your thoracic region.

Often there is neck pain and if it is a referral pain you may get some arm pain, tingling or numbness also, the distribution of the pain in the arm makes it easy to identify where the pain is being referred form. On assessment I can determine on assessment if the pain is being referred from a disc prolapse or facet joint inflammation or degeneration.

From the Thoracic spine

Studies by Dreyfuss et al. (1994) and Young et al. (2008) show that referred pain from the thoracic facet joints and costotransverse joints (The costotransverse joint is the joint formed between the facet of the tubercle of the rib and the adjacent transverse process of a thoracic vertebra) refer pain laterally. So basically the whole upper and midthoracic area can potentially refer pain medial to the scapula (shoulder blade). This will be determined during your examination.


These type of presentations respond very well to spinal mobilisations, if the nerve is being compressed I need to offload this by gapping the joints in specific ways which offer relief.
Stability exercises are also very good at aiding improvements. When pain occurs the stability muscle of the spine can alter their pattern to become phasic (on-off – like a bicep) as opposed to Tonic (held on for long periods) which is the core control of your posture. Also self mobilisation exercises which will be taught can help keep the pain clear in the long term.

Trigger Points

Trigger points are what you may call knots in the muscles in the region between the shoulder blades, These can refer throughout the region and are assessed with pressure on the muscles themselves to review if they reproduce the same pain you experience.


Trigger point treatment includes local tissue manipulation, acupressure and acupuncture, when treating this presentation I will always treat the joints to ensure they are moving well and freely. Self stretches are prescribed and postural advice also.

Kyphosis/ scoliosis
Adolescent Idiopathic Scoliosis(AIS)

AIS is when the spine curves more than 10 degrees and the curves are multidirectional. When you view a normal spine form behind it appears straight, a small amount of curvature is common and not too much of concern (though it can lead to back pain and worse degeneration in maturing years). A Scoliosis is a curve in one direction side to side and is a common problem I successfully treat for many patients. AIS causes a kyphoscoliosis is a side to side and also a back to front curve causing a hump to form in the back. This affects girls more than boys and most often occurs in childhood and early teens as the child grows quickly.

Here is link to a further article I have written on this

Manual therapy treatment I provide can be very effective at helping sort out these problem if addressed early, in some severe cases they may need referring for a surgical opinion.

Solutions to all thoracic pain

All the presentations of thoracic pain will be fully assessed and the cause of the pain will be identified. One of my patients’ problem was due to very tight hamstrings – 4 years of pain and stretching those out cleared his pain in 2 weeks.

Specific treatment hands on and home programmes will be given to help you
re-attain a pain free life.

Call 01962 714979 for an appointment.