Anatomy & Background
A complicated system of ligaments and muscles serves to control movement, maintain posture, and support the lower back and pelvis. Ligaments are fibrous bands of soft tissue that attach a bone to another bone. The ligamentous system of the spine protects the intervertebral discs from injury, and prevents excessive movement of the spine
The muscular system of the lower back is complex, and includes the deep erector spinae or paraspinal muscle groups that run parallel to the spine. In addition there are larger and more superficial muscles that help to move and protect the lower back.
The larger superficial muscles help move and stabilize the lower back. The deeper spinal muscles can be multisegmental connecting and attaching to more than one vertebra or muscles that support, stabilize and move one segment in relation to another.
When thoracic or spinal motion is pushed to the extreme, such as in a car accident or whiplash injury, these ligaments and muscles can be damaged. Ligament damage sprain and muscle damage strain can produce pain, soreness, loss of motion, and if severe enough joint instability.
Injury to the thoracic spine causing weakness or tightness of the muscles or laxity of the ligaments of the lower back can result in pain, decreased ability to maintain good posture, limitation in movement and instability of the back.
Thoracic sprains and strains are a common injury, most often caused by excess weight bearing or lifting, trauma, motor vehicle, and falls. Sharp increases in physical activity or added stress on the ligaments and muscles in the back are also a common cause of thoracic sprains.
- Back pain or tenderness
- Swelling or bruising in the mid back
- Pain when moving or using the back in daily activities
- A “popping” or “tearing” feeling in the mid back
- Warmth or redness of the skin over the injured area
- Decreased ability to move, including performing bending and lifting motions.
If you suspect you have a thoracic sprain, first try avoiding the positions and activities that produce the pain. A course of conservative treatment is usually recommended that includes rest and immobilization, ice, physical therapy and non-steroidal medications to reduce inflammation. If the pain persists, consult with your physician. S/he may recommend steroidal medication or injections, in conjunction with therapy. In severe cases surgical intervention may be needed to repair the torn ligament.
In mild cases patients found that rest, ice and medication were enough to reduce the pain. Physical therapy is recommended to develop a series of postural, stretching and strengthening exercises to prevent re-occurrence of the injury. Return to activity should be gradual to prevent a return of symptoms.
Moderate to Severe Cases
If the problem persists, consult with your health care provider. Your physician will perform a thorough evaluation to determine the possible cause of your symptoms, the structures involved, the severity of the condition, and the best course of treatment.
Procedures that your physician may recommend and perform in addition to physical therapy may include:
- REST and ICE
- Splinting or bracing the affected area
- The use of NSAIDS (Non Steroidal Anti-Inflammatory Drugs)
- Steroidal injections to reduce inflammation
- Pain medication to reduce the discomfort and allow the patient to perform the recommended exercises
- Trigger Point Injections
- Plasma Rich Platelet Therapy