Backache in middle of back

Male, 38 years old. Complaints of central back pain not associated with physical exertion, has been bothering for about six months. The pain is in the middle and lower thoracic spine, and occasionally there is discomfort and restriction of movement in the neck.

Objective examination: the range of motion in the thoracic spine is full and painless (flexion, extension, rotations, and side bends). On palpation: muscles, vertebrae, and other paravertebral structures are painless. Forward bending and turning the neck to the left are somewhat limited by mild pain. The SLUMP test for nerve sheath tension causes the same pain (with both legs simultaneously). There is a limitation of ulnar nerve mobility on the left side.

Diagnosis: dysfunction of nerve sheath mobility in the spinal canal (approximately level T6-7-8), functional joint blockages in the neck, restriction of ulnar nerve mobility on the left side.

Treatment: simultaneous mobilization of nerve structures and vertebrae at the level of T6-7-8, mobilization towards ease of movement C2 - for neck extension, and C3-4 on the left for turning to the left, freeing the nerve roots with simultaneous movement, taping paravertebrally the thoracic spine using decompression technique.

Result recovery of painless mobility in the neck, negative ulnar nerve tension test, does not provoke symptoms. Regarding the main complaint: significant reduction of symptoms when stretching the dura mater, by about 70-80%.
Recommended: self-mobilization of nerves with appropriate exercises and avoiding positions that can provoke symptoms, as stated in the conclusion.

Backaches in the thoracic spine. Conclusions.

A truly interesting and instructive case. An athlete in excellent physical condition who can run a half marathon, firstly. Secondly: movements in the thoracic spine are free and none of them provoke the pain. Palpation is also completely painless, so there are no problems with the soft tissues, confirmed by the complete ineffectiveness of the massages he tried. And yet, regular, annoying pain for a long time!
What is happening? The diagnostic process is not a simple matter, sometimes you have to purposefully extract every crumb of information, like a real detective. During the process of giving recommendations to the patient, it was shown what position NOT to take to avoid chronically stretching and irritating the nerve tissues. And this position, as it turned out, was his favorite reading position! Elementary, Watson? Not really. :)

Grigori Tafi
Osteopath, sports medicine doctor
15 years of experience in osteopathy and manual therapy. Read more...

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