David R. Beatty and Camilia Makyhoun

David R. Beatty, DO, Professor of Osteopathic Principles and Practice, WVSOM

Camilia Makyhoun, Assistant Editor, WVSOM Class of 2016

Wednesday, March 6, 2013

UNWINDING THE UPPER BACK



Thoracic motion (David R. Beatty,
drawing by William A. Kuchera, DO, FAAO)

There's a reason why stress often produces upper back pain. The nerves of the sympathetic nervous system, which respond to physical, emotional, or internal stress, originate in the thoracic spine and can trigger muscle spasm in response to any of those stressors.



DOCTOR'S NOTE: Seek evaluation by a health professional for upper back pain associated with respiratory, heart, or gastrointestinal symptoms that can refer pain to the thoracic area.


THORACIC POSITION OF EASE
Position of ease for right upper back pain (WVSOM)
  1. Lie face down with a pillow or two under your shoulder on the side of back pain and the arm resting comfortably;
  2. Turn your head to the side of back pain and allow it to rest on the pillow;
  3. If back pain is not reduced, add another pillow under your shoulder;
  4. When back pain is reduced, take a few deep breaths and rest in that position for 2-5 minutes;
  5. Proceed to the THORACIC FLEXION/EXTENSION STRETCH or slowly roll to the side before getting up;
  6. Use this position of ease 2-4 times a day or as needed for pain relief.

THORACIC FLEXION/EXTENSION STRETCH
   
Flexion stretch (WVSOM)
  1.   Kneel with your arms straight and hands shoulder width apart;
  2. Arch your back slowly upward while tucking the head and tailbone downward;
  3. Take a few deep breaths and stretch for 5-10 seconds;
  4. Extension stretch (WVSOM)
  5. Arch your back slowly downward while curling the head and tailbone upward;
  6. Take a few deep breaths and stretch for 5-10 seconds;
  7. Repeat the flexion and extension stretches 3-5 times;
  8. If no increase in pain, proceed to the STANDING THORACIC MOBILIZATION;
  9. Do these stretches 1-4 times a day.






Middle thoracic mobilization
(WVSOM)


THORACIC MOBILIZATION STANDING
    1. Stand with arms hanging by your side;
    2. Swing your arms to one side as far as they will go, allowing the back to follow the arms;
    3. Swing your arms to the other side as far as they will go, allowing the back to follow your arms;
    4. Repeat arm swing back and forth 3-5 times, increasing speed each time;
    5. Upper thoracic mobilization
      (WVSOM)
    6. For the upper back, clasp your hands behind the head and swing your arms to one side as far as they will go, allowing the head and back to follow;
    7. Swing your arms to the other side as far as they will go, allowing the head and back to follow;
    8. Repeat arm swing back and forth 3-5 times, increasing speed each time;
    9. Do these mobilizations up to twice a day.











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