OPTIMAL HEALTH UNIVERSITY ™ ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● Presented by Katie Gravesen, DC

Chiropractic for Middle Back The rigidity of the cage limits flexibility and movement in the tho- Part II: Less Common Causes and Research racic spine. Dr. Gravesen explains to patients that this is why middle back Middle is a common reason why patients seek care. pain — while still common — is not Fortunately, chiropractic is highly effective in correcting most cases of middle as prevalent as pain in the more back pain. flexible and lower back areas.

Most cases of pain in the middle back are associated with a widespread condi- Less Common Causes tion called vertebral subluxation. This occurs when spinal movement is re- stricted or spinal bones (vertebrae) become slightly misaligned. Doctors of chi- Fortunately, research shows that over ropractic, like Dr. Gravesen, correct vertebral subluxations with gentle and 99 percent of cases of middle back effective maneuvers called chiropractic adjustments. pain stem from mild and easily treat- able musculoskeletal dysfunctions (Cleve Clin J Med 2008;75:557-66). from below the neck to above the waist. Most of these cases are related to vertebral subluxations and may be The thoracic area is supported by the corrected by chiropractic care. Part thoracic spine, which consists of 12 one of this series discussed these spinal bones called vertebrae. These common causes of thoracic pain. small interlocking bones form a rigid column that houses and protects the Dr. Gravesen also screens patients spinal cord. for less common causes of thoracic pain, some of which may require Each is connected to a rib. referral to another health-care profes- This connection is located at a protu- sional. berance on the sides of vertebrae called a transverse process. The joint receives additional stability from sur- Part one of this two-part Optimal rounding ligaments and muscles. Health University™ series on middle back pain provided an overview of the most common causes of vertebral sub- Tips for Avoiding Middle Back Pain luxation and related pain in the middle From Katie Gravesen, DC back. Now, part two will delve more into the anatomy of the middle back Maintain regular chiropractic visits to keep your back pain-free and and the lesser common causes of mid- achieve optimal health. dle back pain. If you play sports, check your form. Proper form in any sport protects In addition, part two provides a sam- muscles and joints by minimizing overuse and over-extension. pling of scientific research supporting the use of chiropractic for the relief of Keep your core muscles (the chest, spine and pelvis) strong so that they middle back pain. can stabilize your spine. Yoga and Pilates are two great practices for enhancing core strength. Anatomy of the Middle Back Practice sound ergonomics to protect your back. Dr. Gravesen can help The middle back is known as the tho- you analyze your workstation to optimize comfort and spinal health. racic area. The word thoracic is re- lated to . The thoracic area de- fines a portion of the back spanning Katie Gravesen, DC, Sol Chiropractic (808) 270-2530 30 E Lipoa #4-102, Kihei, HI 96753 www.solchiro.com

The less common causes of middle is the most frequent complaint (Am Research also indicates that chiroprac- back pain include: Fam Physician 1992;45:2162). tic care reduces recovery time as well as the need for pain medication to Fracture If the doctor suspects a disc herni- manage back pain (Orthopedics To- ation, imaging studies may be ordered. day 2003;23:14-15). Unlike the spine of the neck (cervical spine), which has far less stability and The good news is that chiropractic This is particularly good news given is more prone to injury, vertebrae in care may offer relief for patients with the myriad side effects of pain medi- the thorax region are considerably disc herniation, often preventing the cations that are often ineffective in more stable. Supported by their sur- need for surgery and extensive reha- reducing back pain. Over-the-counter rounding ligaments, these vertebrae bilitation. pain relievers are linked to ulcers, are also protected by the rib cage. stomach bleeding, asthma and breast However, it is still important to rule One study followed 49 patients with a . And, research shows that ster- out fracture in this area, especially in herniated disc and radiating pain. The oid injections for back pain often cases of trauma. patients underwent chiropractic care cause complications including herni- and . After an average ated discs and infections (Chiropr According to research “the common- of 13 visits, the patients reported an Osteopat 2009;17:6). est cause of fractures of the thoracic average improvement of 78 percent. lumbar spine is hyperflexion with What’s more, nearly 90 percent rated Middle Back Pain? We Can Help! rotation resulting from falls, direct their improvement as either “good” or trauma, or road traffic accidents.” (Br “excellent.” If you suffer from middle back pain, Med J 1993;307:1552.) schedule an appointment for a chiro- These results remained over the long- practic evaluation today. The doctor Fracture is also a real possibility in term. When the researchers followed will screen you for common and less sports injuries. Researchers explain up 14.5 months later, the patients rated common causes of this widespread that because symptoms of trauma in their improvement an average of 81 condition. this “relatively immobile area of the percent, with 80 percent of patients spine may be nonspecific, a thoracic rating their improvement as “good” or spinal fracture may go undetected, “excellent.” (J Manipulative Physiol possibly exposing the individual to Ther 2009;32:723-33.) further injury if athletic activities are resumed.” (Am J Sports Med Organ Problems 1993;21:57.) In rare cases, in the mid- may also be subject to fracture, dle back can be a sign of a gall bladder especially in cases of trauma, such as disease, a kidney stone or a cardiovas- a sports injury or motor vehicle acci- cular problem. In even more rare in- dent. stances, thoracic pain may indicate cancer in the or breasts. If the If the doctor suspects a fracture, x- doctor suspects an organ may be the rays or other imaging studies will be source of your middle back pain, you ordered. will be referred to an appropriate health-care professional. Herniated Disc Have you read part one of this series? Research Supports Chiropractic This Optimal Health University™ Intervertebral discs are “cushions” handout is part two of a two-part se- between spinal bones (vertebrae). The Research backs up the efficacy of chi- ries on middle back pain. If you center of these discs is a gel-like sub- ropractic care for middle back pain. missed part one, please ask at the stance, which is surrounded by a more For instance, one study revealed that front desk for a copy. fibrous perimeter. A disc prolapse or chiropractic greatly outperformed a herniation occurs when a portion of placebo treatment for thoracic pain Optimal Health University™ is a professional service of PreventiCare Publishing®. The information and recom- the gel-like center moves into the both immediately and one month after mendations appearing on these pages are appropriate perimeter of the disc, causing the care (J Manipulative Physiol Ther in most instances; but they are not a substitute for consultation with a health care provider. Optimal edge of the disc to jet out. In some 2001;24:394-401). Health University™ may be photocopied (NOT re- cases, the gel-like substance leaks out printed) exactly as they are published noncommercially of the disc. In a massive survey of over 2,000 pa- by current subscribers ONLY to share with patients or potential patients. Optimal Health University™ may tients, chiropractic care was rated NOT be reprinted in any print or electronic publication Herniated thoracic discs are less com- “very helpful” in relieving back pain including newsletters, newspapers, magazines or Web sites. Any other reproductions are subject to Preventi- mon than cervical or lumbar ruptures. by 61 percent, while just 27 percent Care Publishing® approval. Copyright, 2017. Preventi- However, they do occur. Pain radiat- said the same of conventional medi- Care Publishing® . 1-831-313-0335. ing outward from the mid-back region cine (Spine 2003;28:292-7). www.preventicare.com