From the Research
Physical therapy is a highly effective treatment for managing mid-back pain, and it should be the first line of treatment, focusing on both pain relief and addressing underlying causes. Treatment typically begins with a thorough assessment to identify specific issues, followed by a personalized program combining manual therapy techniques, therapeutic exercises, and postural education 1. Manual therapy may include soft tissue mobilization, joint mobilizations, and myofascial release to reduce muscle tension and improve thoracic mobility. A progressive exercise program should target strengthening of the thoracic spine stabilizers, including the rhomboids, middle trapezius, and erector spinae muscles, while also addressing core stability.
Some key points to consider in the management of mid-back pain with physical therapy include:
- Patients should perform exercises like thoracic extensions, rotations, and scapular retractions daily, gradually increasing intensity as pain decreases
- Postural correction is crucial, as poor posture often contributes to mid-back pain; therapists will provide specific ergonomic recommendations for work and daily activities
- Heat therapy before exercises and ice after can help manage pain and inflammation, as supported by a recent study on the role of superficial heat therapy in the management of non-specific, mild-to-moderate low back pain 2
- Most patients experience significant improvement within 4-6 weeks of consistent therapy, though complex cases may require longer treatment
It's also important to note that the evaluation process itself can have a therapeutic effect, with a study showing that patients experienced a significant reduction in pain after history taking and physical examination 3. Additionally, heat and cold therapies can be used to facilitate pain reduction and promotion of healing, with heat therapy providing short-term reductions in pain and disability in patients with acute low back pain 4.
Overall, physical therapy is a highly effective treatment for managing mid-back pain, and it should be the first line of treatment, focusing on both pain relief and addressing underlying causes, as supported by the most recent and highest quality study 1.