Improving Thoracic (Mid-Back) Spine Mobility Can Decrease Neck and Low Back Pain

By Dr. Alexis Reinbolt PT, DPT, CSCS

Sitting behind a desk all day can lead to a variety of problems and pains. Common complaints that we see in physical therapy are low back, neck, and shoulder pain that is worse after sitting for long periods of time. Although these complaints all come from different body regions, there is one factor they can all have in common: decreased mobility of the thoracic spine.

What is the Thoracic Spine?


The thoracic spine is the middle section of our vertebrae between the neck and lower back, often called the midback. Thoracic mobility can be defined as the available motion and movement of this part of our spine. Impaired mobility in this region can cause significant pain and stiffness and can affect:
• Posture
• Breathing
• Neck and low back mobility
• Shoulder motion

Prolonged periods of sitting can lead to an increased rounding of the thoracic spine, what we commonly call “slumped” posture. When our spine is in this rounded position, it decreases our ability to move and rotate the thoracic spine in other directions. This posture also commonly co-occurs with a forward head position and rounded shoulders, which can cause neck pain and limit our shoulder motion. It can also increase stress on the low back, causing pain.

What can I do to Improve Mobility?

Physical therapy and exercise can help improve motion in our thoracic spine, which will decrease midback pain and stiffness. Exercises that can help improve mobility include:

  • Open books
    • Lie on your side with knees bent and your arms straight in front of you on top of each other. Slowly lift your top arm over your body and behind your back while letting your chest open and follow the arm. Repeat 8-10 times.
  • Latissimus dorsi prayer stretch
    • Find a low bench or chair and kneel in front of it. Place your elbows on the chair, and then bring your chest towards the floor. You should feel a stretch in your midback. For added difficulty, hold a PVC pipe or yardstick in your hands and keep them ~6-12 inches apart.
  • Foam roller arm exercises
    • Place foam roller between your back and the wall. Keep your back straight and shoulders back, then perform some small snow angels 8-10 times. This exercise can be modified to lie on the floor on the foam roller for people that can safely get on the floor.
  • Thread the needle (with variations)
    • This exercise emphasizes rotation through your midback region. Go slowly through the motion. You can modify the exercise on your hands and knees, bending over while standing, while squatting, or in a lunge position.

What can I do to Improve Strength?


Once you’ve achieved more mobility in your thoracic spine, it is important to strengthen postural muscles to maintain that mobility. Strengthening exercises can include:

  • Rows
    • Place a band in a doorway or around a pole. Use muscles between shoulder blades to bend your elbows and bring them behind your trunk.
  • Straight arm low rows
    • Place a band in a doorway or around a pole. Keep elbows straight and forearms down. Start with arms at 60* in front of you, then bring band handles to your pockets.

Another option for improving mobility acutely can involve thoracic manipulations aka “cracking” the back or other manual therapy techniques. This should be performed in clinic and under the supervision of a trained professional, like a physical therapist.

If you are experiencing mid-back pain and stiffness, contact us at Balance Physical Therapy. We have locations throughout the Central Coast, including Salinas, Prunedale, and Monterey. We offer a wide variety of services to help decrease pain, improve strength and mobility, and optimize overall function. All of our highly trained clinicians will be able to provide you with an individualized program in order to meet your goals and improve your quality of life. Contact us today to schedule an appointment.

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