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The Thoracic Spine and Neck Pain

The Thoracic Spine and Neck Pain
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Neck pain is a very common condition that is the second most common reason patients seek chiropractic care (after low back pain). The term “mechanical neck pain” is a common classification defined as pain located in the cervical spine or cervicothoracic junction that is elicited and/or exacerbated by cervical motion and/or palpation of cervical musculature. While it’s understandable that neck pain should be traced back to dysfunction in the neck itself, it’s suggested that the thoracic spine or mid-back may contribute to or even be the cause of neck pain in some patients.

These days, as we spend more and more time looking at screens, it’s becoming more and more common for individuals to develop postural abnormalities like forward head posture. When the head rests forward of the shoulders, the upper trapezius muscles that connect the rear of the neck and the upper back must work harder to keep the head upright. This prolonged muscle strain can lead to inflammation, which can be felt as neck pain. In fact, an April 2023 study that examined 148 adults, half with neck pain, identified an association between abnormal mid-back posture and neck pain. Similarly, a December 2022 study found that individuals with neck pain are more likely to exhibit hypermobility in the upper thoracic region.

To identify if treatment aimed at improving function in the thoracic spine can benefit neck pain sufferers, researchers performed a systematic review and meta-analysis of eight randomized controlled trials published between 2010 and 2020 that included a total of 457 patients. Their analysis revealed that thoracic thrust manipulation—a form of treatment performed by doctors of chiropractic—led to a significant reduction in neck pain and disability, more so than other treatment options including non-thrust manipulation, mobilization, strengthening exercises, infrared therapy, placebo, or no treatment. The authors point out that this study provides evidence that thoracic spine manipulation is an effective intervention for patients with mechanical neck pain and should be considered as part of a multimodal approach for managing the condition.

Other studies have found that dysfunction in the mid back may also contribute to shoulder impingement syndrome and low back pain. This highlights the importance of examining the whole patient when they present for care and not just their area of chief complaint—something doctors of chiropractic are trained to do.  If you suffer from neck pain and visit a doctor of chiropractic, don’t be surprised if treatment also includes a mid-back adjustment. It may be just what’s needed to alleviate your neck pain and return you to your normal activities.


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