Back pain is a very common complaint among people of all age groups. It is, however, more commonplace among people in their thirties and onwards, but is not unfamiliar to those younger due to the increasing demand to sit (sedentary lifestyle).
Back pain is mostly due to degenerative (wear and tear) changes in the spine and is usually part of a progressive degenerative disease. Thus, the underlying problem responsible for back pain will slowly but surely worsen over time if not addressed promptly. So how is it that people who are so young can have a condition related to degeneration? Poor sitting posture, lack of exercise and weak back extensors. Many of the spinal structures such as the intervertebral disc, which act like shock absorbers and the ligaments that hold the spine together need to be very elastic for them to do their job and as a result have evolved to survive with a very sparse blood supply. The stretching and relaxation and the loading and unloading of these structures cause nutrients and oxygen to be sucked in and waste products pumped out. So as we tend to be more stationary at work i.e. sitting all day, have entertainment that require sitting (TV, movies), and sitting to travel to all our destinations, these structures no longer get their needs met and hence undergo degenerative changes, not to mention that sitting for periods causes weakening of the supportive structure muscles of the spine.
Mechanical back pain/Rib Pain
Mechanical back pain is the kind of back pain that comes when doing normal things; bending to make the bed, poor sitting posture, congenital (scoliosis, scheuermann’s disease), serving a tennis ball, weeding in the garden, etc. These are actions that we shouldn’t get injured doing.
Overtime, either due to postural stresses or past injury we develop fibrous reinforcement through our soft connective tissue of the spine (muscles, ligaments, disc, joint capsule, etc). This reinforcing tissue is strong but not very elastic and interferes with the way the spine moves and can render the spine vulnerable during normal everyday activities. The spinal structures become strained when they can not stretch or cope with the loads they need to endure. Subsequently, an altered movement pattern arises as the joints involved lose mobility and surrounding joints compensate by taking on their load to produce the overall movement required. Depending on how long it takes to be addressed, the altered movement patterns of the joints involved undergo degenerative changes and compensatory changes occur.
Sciatica (Radicular pain)
This is pain that is caused by a pinched nerve and the pain will travel down the length of the nerve and be most severe at the distal point of the nerve, but can manifest at any point along the length of the nerve around the chest wall and side of the ribs. When there is compression of this nerve root, you will experience pain over the area supplied by that nerve which may be present as a sharp-shooting electric pain with associated numbness, tingling and/or weakness. Both the physical compression of the nerve root and the inflammatory changes in and around the nerve root are responsible for the pain.
Thoracic Pain Treatment
Treatment at George St Chiropractic is aimed at restoring the back movements so that the soft tissues and joints of the back can move freely and cope with normal activity without getting distressed so that tissues can repair as soon as possible.
We massage and loosen the tight structures that are involved so that we can gently and safely restore movement. As mentioned above, it is movement that enhances the supply and drainage to the spinal structures. The methods of loosening joints are decided by you after discussing options with your chiropractor. Spinal manipulation in the form of gentle adjustments may be offered or alternatively a specialised mobilisation may be used. Some people have contraindications or may be fearful of manipulation so for these people the mobilisation technique is a great choice.
Our Chiropractors at George St Chiropractic always take a detailed history and thorough physical examination. If you have any previous imaging like X-ray, CT or MRI, it is important for us to see them and sometimes more current imaging may be requested in our assessment, which Dr. Steve Crome and Dr. James Kerr can arrange. We also place a big emphasis to limit any manipulation to an extremely gentle force. We then advise the patient on postural tips and preventative exercises included.
Being one of the leading Chiropractors in the Sydney CBD, treating all who come through the door is our top priority.