The MSK Studio - spinal physiotherapy and Clinical Pilates clinic in Adelaide

Thoracic & Upper Back Pain

Region affected

Thoracic spine / Ribcage

Common in

Adults 25–55

Onset

Gradual or acute

Related conditions

Rib Pain, Neck Pain, Facet Joint Syndrome

Thoracic and upper back pain refers to pain arising from the thoracic spine, the twelve vertebrae of the mid and upper back, from the base of the neck to the bottom of the ribcage. While less common than lumbar or cervical pain, thoracic spine dysfunction is regularly seen at The MSK Studio in Adelaide and is frequently a contributing factor in both neck pain and low back pain presentations.

The thoracic spine is inherently more stable than the cervical or lumbar regions due to its attachment to the rib cage, but this stability comes at the cost of mobility, and stiffness in the thoracic spine is extremely common, particularly in people with desk-based occupations, overhead work or postural loading. Thoracic stiffness can place increased demand on the adjacent cervical spine and shoulder, contributing to neck pain, headache and shoulder dysfunction.

What Causes Thoracic and Upper Back Pain?

Signs and Symptoms

Thoracic and upper back pain can arise from a range of structural and postural causes:

Thoracic pain presentations vary considerably depending on the structure involved:

  • Facet joint dysfunction or stiffness at a thoracic level
  • Costovertebral joint dysfunction – where the ribs attach to the thoracic vertebrae
  • Disc pathology in the thoracic spine
  • Postural loading from sustained sitting, screen use or overhead work
  • Acute sprain or strain of the thoracic muscles or ligaments
  • Rib pain arising from the rib itself or its junction with the thoracic vertebra
  • Aching or sharp pain in the mid or upper back, often close to or between the shoulder blades
  • Stiffness in the thoracic spine, particularly with rotation
  • Rib pain that worsens with deep breathing, coughing or certain arm movements
  • Pain that refers around the ribcage or into the chest wall
  • Upper back pain associated with prolonged sitting or poor posture
  • Thoracic pain contributing to neck stiffness or shoulder restriction

What Causes Thoracic and Upper Back Pain?

Thoracic and upper back pain can arise from a range of structural and postural causes:

  • Facet joint dysfunction or stiffness at a thoracic level
  • Costovertebral joint dysfunction – where the ribs attach to the thoracic vertebrae
  • Disc pathology in the thoracic spine
  • Postural loading from sustained sitting, screen use or overhead work
  • Acute sprain or strain of the thoracic muscles or ligaments
  • Rib pain arising from the rib itself or its junction with the thoracic vertebra

Signs and Symptoms

Thoracic pain presentations vary considerably depending on the structure involved:

  • Aching or sharp pain in the mid or upper back, often close to or between the shoulder blades
  • Stiffness in the thoracic spine, particularly with rotation
  • Rib pain that worsens with deep breathing, coughing or certain arm movements
  • Pain that refers around the ribcage or into the chest wall
  • Upper back pain associated with prolonged sitting or poor posture
  • Thoracic pain contributing to neck stiffness or shoulder restriction

How The MSK Studio Treats
Thoracic & Upper Back Pain

At The MSK Studio in Adelaide, thoracic and upper back pain is assessed as part of the broader spinal picture, including the cervical spine and shoulder where relevant. Thoracic facet and costovertebral joint mobilisation is highly effective for thoracic stiffness and is a core part of treatment. Postural education, thoracic mobility exercises and progressive strengthening of the thoracic and scapular stabilisers complete the rehabilitation program.

See our back pain physiotherapy service below:

Back Pain Physiotherapy

Related Conditions

Rib Pain

Facet Joint Syndrome

Whiplash

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