The Thorax (Chest and Upper Back)

The thorax is the area of the body between the base of the neck and the diaphragm. It encompasses 12 vertebrae, the heart, lungs, and countless nerves. We often see patients with neck or lower back pains, and end up treating the thoracic area, even if it’s asymptomatic. Although it’s a very stable part of the body, it can hold areas of restriction that cause problems elsewhere, even if there are no local symptoms at all.

The Thorax and Pain Elsewhere

The thoracic spine is the least mobile of all three areas (cervical/neck, and lumbar/lower back). The reason for this is that each vertebra has a pair of ribs attached, which limit all ranges of movement. Most of these ribs attach directly or indirectly to the sternum (breast bone) at the front, further limiting movement. As a result, other areas of the back have to absorb movements that might otherwise dissipate through.

When a patient presents with a lumbar disc issue, the first question is “why?”. Often the answer has something to do with excess restriction in the thoracic spine. This can go undetected, as movement is small anyway, but restriction is typically painless. Modern life asks us to spend a lot of time still, potentially also sitting at a desk. Although desk work is not inherently bad for you, it’s easy to forget to move and to spend too long in a slumped position. Holding this position can cause the chest muscles to tighten, bringing your shoulders forward.

Thoracic Outlet Syndrome

One ailment with unsurprising links to the thorax is Thoracic Outlet Syndrome (TOS). Also potentially associated with the “desk posture” mentioned above, the nerves exiting the top of the thorax and running into the arm can be compromised. Compression around the base of the neck and tops of the shoulders can cause pain, numbness, and tingling from the shoulder to the hand. Click here to read more about TOS.

The Benefits of Stability

Despite all of this, there are benefits to a stable thorax! Disc bulges in the thoracic spine are much less common than either lumbar or cervical disc issues. Similarly, arthritic upper backs are much less likely than the neck or lower back too. Of course, the rib cage demands stability for a good reason. The lungs need protected space to work safely.

Keeping the Thorax Happy

One easy fix for the thorax is to improve your breathing. The image above shows the two movements the ribs should do during normal breathing. The upper ribs move like a “pump handle”, straight out like a hinge. The lower ribs flare wide like a “bucket handle”. And ultimately, the breath should feel like it comes from the abdomen. Stress makes us breathe more shallowly, with the muscles in the tops of the shoulders engaging to pick up the slack. If you tune into your own breathing, you might find that your tummy barely moves on each breath. If you struggle with tension, especially stress that sits on your diaphragm and stops you breathing deeply (potentially causing reflux too), there’s something to address!

Your osteopath can look at the way your whole body functions to see where any aymptomatic symptoms lay. We use a range of techniques and exercises to restore balance and function to the thorax and beyond.

Click here to make an appointment in the Camberley area