thoracic spine, level 9 pain

[Millie]

Hello,

I have posted this under an annoymous name as I am a physio and I feel that I should really know the answer. I am fit healthy individual but with a terrible 'un physio' posture:- FHP, increased kyphosis of the thoracic spine (I have a very prominent boney thoracic spine which I have had manipulations on in the past P/A as this is the area where I tend to ache - between the shoulder blades). I also have a very increased lordosis of the LX. I work in the community and rather sillily I carry around a rather big and full ruc sack on my back. About 1.5 months ago, i noticed that where the ruc sack was resting on my back, it was very painful on my T9 level of my spine. Since then, my T9 continues to be very sore on slight touch or if increased pressure is accidently applied to it. i still wear my ruc sac daily but it is positioned on a part of my back where it won't put pressure on my T9. I have booked a GP appointment and I am worried that this could be the start of a problematic back problem - does anyone have any thoughts on what this could be? I tend to hinge on my L1/L2. It is not painful on the T spine levels below and above T9. I always try to adopt a corrected posture, and always incorporate my core tummy muscles.
I have no neuro signs and hopefully won't go on to develop any.

I would be grateful for any suggestions
thanks

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[physiobob]

Sounds like you've answered it yourself. To much Tx kyphosis with a corresponding Lx lordosis to match. If the spinous processes are prominent then it is easy enough to have them become hypersensitive. Wearing a back pack is not likely to help your situation. I would work on getting mobility in your toracic spine both in extension and rotation with similar adjustment to your Lx. You might find some simple kinesiotaping to assist postural awareness might help to take the End of Range load on the apex of your Tx kyphosis. Adjusting your pelvic position won't help if the rest of the spine doesn't have the mobility to happily accept the altered posture. Tight pecs, rib cage etc need to be eased out while strengthening Tx extension and rotation musculature.

Remember the body does not like to rest at an end of range position. So to achieve an erect spine you need to be able to move well beyond that into Tx extension such that what you want at rest it not the end of range that is possible.

[Millie]

Dear physiobob,

thank you for this advice - i am so grateful! in hindsight, i was thinking all of the things you have suggested. it makes total sense. I struggle so much with understanding msk physio (I have no logic or mechanical way of looking at things!!! but i do find that I am getting better...!).
many thanks and i feel quite confident that i can repair myself!
best wishes