Mid spine pain
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Understanding Mid-Spine Pain: Incidence, Risk Factors, and Treatment
Incidence and Prevalence of Mid-Spine Pain
Mid-spine pain (MBP), also known as mid-back pain, is a common condition that affects individuals across various age groups. Despite its prevalence, research into the epidemiological aspects of MBP has been relatively scarce compared to neck and low back pain. A systematic review highlighted that MBP affects individuals' quality of life to a similar degree as other spinal pain conditions, yet it remains under-researched1. In a study involving 34,902 Danish adults, it was found that the prevalence of MBP is significant, though it is less common than neck and low back pain6. Another study focusing on Finnish men reported a 1-year prevalence of 17% for MBP, which is notably lower than the prevalence rates for neck and low back pain10.
Risk Factors for Mid-Spine Pain
Physical and Psychological Factors
In adolescents, both physical and psychological factors contribute to the development of MBP. A systematic review identified that certain aspects of sagittal alignment in sitting and standing postures, such as increased lumbar lordosis and sway-back posture, are associated with MBP2. Psychological factors, although not the primary focus of this review, are also considered significant contributors to spinal pain in this age group.
Age and Gender Considerations
The prevalence of MBP does not necessarily increase with age. A systematic literature review found that back pain, including MBP, does not become more common in the elderly population compared to middle-aged individuals. In fact, the prevalence of back pain tends to decline in the oldest age groups8. Additionally, a cross-sectional study of 34,902 individuals revealed that women are slightly more likely than men to report consequences due to spinal pain, including MBP9.
Treatment and Management of Mid-Spine Pain
Manual and Physical Therapy
Manual therapy, including thoracic spine and costovertebral joint manipulation, has been studied for its effectiveness in treating MBP. A clinical trial at the Durban University of Technology found that both thoracic facet joint manipulation alone and in combination with costovertebral joint manipulation significantly decreased pain perception and increased pressure pain thresholds. However, there was no significant difference between the two treatment methods, suggesting that costovertebral joint manipulation may not be necessary for effective MBP treatment3.
Exercise and Rehabilitation
Exercise targeting the mid-thoracic spine can also be beneficial. A randomized controlled trial involving elite cross-country skiers demonstrated that exercises focusing on proper trunk stabilization and segmental spinal movement significantly reduced pain intensity and frequency in the thoracic area. These exercises also improved sensory perception, including graphesthesia and vibration perception5.
Radiofrequency Denervation
For chronic MBP, medial branch neurotomy, a form of radiofrequency denervation, has shown promise. A systematic review of randomized trials and observational studies provided strong evidence that radiofrequency denervation offers short-term relief and moderate evidence of long-term pain relief for facet joint-origin pain, including MBP7.
Conclusion
Mid-spine pain is a prevalent condition that affects individuals of all ages, though its incidence is lower compared to neck and low back pain. Physical factors such as posture and alignment play a significant role in the development of MBP, particularly in adolescents. Effective treatment options include manual therapy, targeted exercises, and radiofrequency denervation. Further research is needed to fully understand the epidemiology and optimal management strategies for MBP.
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Most relevant research papers on this topic
Incidence and prognosis of mid‐back pain in the general population: A systematic review
Mid-back pain is common in early life and affects quality of life similarly to neck and low back pain, but research on its incidence and prognosis is scarce.
Systematic ReviewPhysical risk factors for adolescent neck and mid back pain: a systematic review
Sagittal alignment in sitting and standing postures may be potential risk factors for adolescent neck and mid back pain.
Systematic Review
Rigorous JournalThe effect of thoracic spine manipulation compared to thoracic spine and costovertebral joint manipulation on mechanical mid-back pain at the Durban University of Technology Chiroptractic Day Clinic
Combining thoracic facet and costovertebral joint manipulation significantly decreases pain perception, pressure pain thresholds, and thoracic spine range of motion in patients with mechanical mid-back pain.
RCTAn 11-year-old high-level competitive gymnast with back pain
Avulsion of the anterior ring apophysis of L1 vertebral body was diagnosed, causing continuous back pain and limited range of motion during jumping and running.
Case ReportCan Exercise Targeting Mid-Thoracic Spine Segmental Movement Reduce Back Pain and Improve Sensory Perception in Cross-Country Skiers?
Exercise targeting the mid-thoracic spine may decrease back pain and improve sensory perception in cross-country skiers.
RCTPain in the three spinal regions: the same disorder? Data from a population-based sample of 34,902 Danish adults
Back pain and its consequences share many characteristics and may be considered the same condition regardless of where it occurs in the spine, but separate entities may exist for lumbar spine pain.
Observational StudyRigorous JournalMedial branch neurotomy in management of chronic spinal pain: systematic review of the evidence.
Radiofrequency denervation offers short-term relief and moderate long-term pain relief for chronic spinal pain caused by facet joints.
Systematic Review
Highly CitedDoes back and neck pain become more common as you get older? A systematic literature review
Back pain does not increase with age, but may decline in the oldest individuals.
Systematic ReviewRigorous JournalConsequences of spinal pain: Do age and gender matter? A Danish cross-sectional population-based study of 34,902 individuals 20-71 years of age
Most people with spinal pain manage without serious consequences, but low back pain often leads to consequences like care-seeking, reduced physical activities, and disability pension, with a slight predominance of women reporting consequences.
Observational Study
Very Rigorous JournalPrevalence and Characteristics of Upper or Mid-Back Pain in Finnish Men
Mid-back pain is approximately one fourth as prevalent as neck and low back pain in Finnish men, with less disability and nearly always spinal comorbidity.
Observational Study