Dealing with mid back pain?

You just might have poor ergonomics

Medical researches have shown that muscular strain is the major cause of middle back pain among desk/computer workers. The back muscles and tendons provide support to the thoracic spine and the ribs of your back.  They are the muscles that take the stress that may arise from activities like sitting, lifting of heavy objects, running, exercising, etc…. Sitting in wrong postures for long periods of time can also weaken and fatigue mid back muscles. As a result, strains or spasms may occur.  

In addition, your thoracic spine is articulated with you rib cage. Is the event of wrong exercise or over exercising it can lead to misalignment of the ribs and result in sharp pain of the mid back complex while taking a deep breath. Spinal and rib manipulation in particular is very effective to treat this type of condition in conjunction with physiotherapy to strengthen the mid back complex.


Upper-Crossed Syndrome (UCS)

A common disorder seen in our office is Upper-Crossed Syndrome (UCS) (Janda 1988). In UCS, tightness of the upper trapezius and levator scapula on the posterior side crosses with anterior tightness of the pectoralis major and minor. Weakness of the deep cervical flexors muscles crosses with weakness of the middle and lower trapezius. This pattern of imbalance creates joint dysfunction, particularly at the Co-C1, C4-C5 segment, cervicothoracic joint, glenohumeral joint, and T4-T5 segment. 

Specific postural changes are seen in UCS, including forward head posture, increased cervical lordosis and thoracic kyphosis, elevated and protracted shoulders, and rotation or abduction and winging of the scapulae. These postural changes decrease glenohumeral stability as the glenoid fossa becomes more vertical due to serratus anterior weakness leading to abduction, rotation, and winging of the scapulae. This loss of stability requires the levator scapula and upper trapezius to increase activation to maintain glenohumeral centration (Janda 1988).

To sum it up, a patient generally presents a posture of forward head, shoulder anteriorly rounded, and shoulder blade winging. You may notice you have a hard time sitting up straight at your desk and are more comfortable slouching. This is due to mid back weakness and tight anterior neck and chest muscles such as SCM, scalens and pectoral muscles.

Besides looking like a hunchback or little old lady, UCS can lead to many musculoskeletal disorders such as rotator cuff instability leading to impartial tear or labrum tear, headaches, numbness and tingling in the arms, and/or early onset osteoarthritis in the neck and mid back.

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