Case Example of the Week: Recent Rib and Back Pain

I had a patient come in this week with about a week’s worth of pain on the right side of her mid-back, nestled right between the shoulder blade and her spine. She was asking if we were able to help treat this, and after a few quick questions I confirmed that absolutely, this kind of spinal pain is in our wheelhouse.

A few quick details: She had no real tenderness to the muscles over the area, the middle of the spine wasn’t painful, and there was no recent accident or trauma, and no medical conditions affecting her bone health or anything else. She mostly noted that not many positions relieved it outside of certain times laying down, and her back felt tired by the end of the day. 

After an examination, I found that pressure just to the side of the vertebrae reproduced her pain, but not from any rib mobilization. She also felt some pain with standing global extension and end range rotation of the mid back when I applied some extra pressure.

We got down to treatment right away: A mid-back manipulation to decrease sensitivity while we start to move, some mobilization in sitting into extension and rotation, and then some exercises.  I love to address this type of subacute pain for most patients by using some “movement snacks”, breaking the day up with quick 30-60 second movements for introducing variety and breaking up sedentary time. Usually this is tricky to remember until you add in some timers on your phone to keep you on track.  

Thoracic whips were the movement of choice for her: She felt some relief rather immediately, the first time since the pain came on. This video by Erson Religioso is my favorite for how to create some quick changes in mid-back pain once it’s been evaluated. I gave her a guideline for how often to do them and discussed next steps that within a week we could look at how irritated her mid-back extension felt and whether we could load into that position. 

Seeing some changes but still want a more individualized approach to your rehab? Looking for physical therapists in Long Beach who understand what it takes to make fitness a daily part of your life? If you want to learn how to take control with some expert guidance and treatments to optimize your performance and longevity, then that’s exactly what we provide at Zenith Performance Physical Therapy. Call or text us at 562-502-1767 to schedule a free phone consultation and come in for an evaluation! 

Thomas Bilodeau, PT DPT, USAW-L1

Zenith Performance Physical Therapy 

ICE Certified Specialist: Orthopedics, Fitness Athlete, Older Adult