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Thoracic Spine Sprain

Thoracic spine sprains are a frequent problem that can occur when the ligaments in the middle back area get injured. This can lead to troublesome symptoms like pain, stiffness, and muscle spasms, making it difficult to move comfortably and perform your everyday activities. 

The good news is that there are treatment options readily available, ranging from simple techniques like applying heat or taking over the counter medication, to more advanced regenerative treatments like Platelet-Rich Plasma (PRP) and bone marrow concentrate.

The innovative procedures of PRP and bone marrow concentrate are performed by the skilled specialists at the Centeno-Schultz Clinic, who prioritize your well-being and aim to help you find relief and improve your quality of life.

So, if you’re experiencing thoracic pain, don’t hesitate to seek expert care and explore the possibilities of effective treatment. Remember, you deserve to live comfortably and freely without the limitations that come with thoracic spine sprains.

What Is A Sprain Of The Thoracic Spine?

Ligaments are thick pieces of connective tissue that connect bone to bone. Think of them as duct tape. There are ligaments throughout the body including the cervical, thoracic and lumbar spine.  The thoracic spine is that section of the spine below the neck and above the low back. Oftentimes it is referred to as the middle back.

A sprain is an injury to the ligament in which the ligament is stretched, torn or ruptured.  Ligament injuries are graded based upon the severity of the injury(1).

  • Grade 1: Mild: Ligament is stretched but not torn
  • Grade 2: Moderate: Ligament is partially torn
  • Grade 3: Severe:  Complete tear of the tendon

Sprain of the thoracic spine is an injury of one or more of the supporting ligaments in the thoracic spine that can lead to pain in the middle back, restriction in range of motion and muscle spasm.

There are 9 important ligaments in the thoracic spine which are susceptible to injury leading to pain and dysfunction.  They include:

  1. Radiate Ligament
  2. Lateral Costotransverse Ligament
  3. Superior Costotransverse Ligament
  4. Intertransverse Ligament
  5. Anterior Longitudinal Ligament
  6. Posterior Longitudinal Ligament
  7. Ligamentum Flavum
  8. Supraspinous Ligament
  9. Interspinous Ligament

Symptoms Of Sprain In The Thoracic Spine

Thoracic spine ligaments have many important functions that include providing stability for the thoracic spine, limiting movement, providing support for the upper body and protection of spinal structures that include the discs, facet joints, nerves. Thoracic spine sprains can cause a number of different symptoms that include:

Pain In The Middle Or Upper Back

Thoracic spine sprains can lead to mid back pain for a number of different reasons.  Injury of the ligament can cause inflammation which can cause pain. Ligaments have pain fibers which when injured or stretched can be painful.

Ligaments provide critical support and when injured can change the mechanics of the spine. Finally, thoracic spine ligament injuries can lead to spinal nerve irritation or compression.

Stiffness Or Limited Range Of Motion In The Affected Area

Ligament injury in the thoracic spine can result in stiffness and restriction in range of motion.  This is due to the inflammation following the ligament injury and altered biomechanics. Changes in muscle tone and guarding may contribute to stiffness.

Muscle Spasms In The Back

Injury to thoracic spine ligaments typically triggers an inflammatory response with the release of inflammatory agents such as prostaglandins and cytokines. Muscles in the thoracic region become tense in an effort to protect the injured area. 

The muscles may involuntarily contract or spasm to provide protection and stability.  These muscle spasms can lead to limited range of motion and stiffness.

Tenderness Or Sensitivity To Touch In The Affected Area

Injury to the thoracic ligaments triggers an inflammatory response with release of inflammatory agents.  This can cause significant tenderness and sensitivity. 

Difficulty Breathing Deeply

The inflammatory response from ligament injury along with muscle guarding can cause difficulty in breathing.  Patients may complain of shortness of breath or inability to take a deep breath. 

Common Causes Of Sprains In The Thoracic Spine

There are many different causes of thoracic spine ligament injuries.  The three most common include:


Traumatic injuries such as motor vehicle accidents, falls, and sports related injuries can significantly damage the ligaments in the thoracic spine. Flexion/ distraction injuries are common (2).  Examples include seat belt injuries where abrupt deceleration causes flexion of the trunk with injuries in the thoracic and lumbar spine.

Repetitive Activities

Repetitive activities can put excess pressure and stress on the thoracic spine ligaments leading to injuries. Examples include occupations and sports that involve repetitive bending and lifting. Poor posture can also put excessive strain on the thoracic spine ligaments leading to potential injury.

Thoracic Disc Degenerative Disease

Degenerative disc disease is a medical condition characterized by a gradual deterioration of the discs in the spine. This involves many changes that include a  reduction in the height of the disc along with decreased ability to function as a shock absorber.

Thoracic spine ligaments can also undergo degenerative changes which include loss of elasticity and strength. This makes the ligaments  susceptible to injury including sprain.

When To Consult A Specialist

Thoracic spine injuries and dysfunction is poorly understood and oftentimes ignored.  This is in part due to the complexity of the anatomy and the multiple potential sources of pain.  All too often attention and treatment of thoracic injuries centers around management of symptoms: pain, muscle spasm and restriction in range of motion.

These persistent symptoms are a warning signal that you have a significant medical problem that warrants additional evaluation.  Anything less will compromise the outcome.  In addition a small issue may become a larger one limiting treatment options.

Common Treatments For Sprains Of The Thoracic Spine

It is common to use a combination of treatments for thoracic spine strains to effectively manage symptoms. These therapies are often used together to complement each other and achieve the best results in symptom management.

Heat Or Cold Therapy

Heat and cold therapy are common for managing the symptoms of thoracic spine sprains. Heat therapy, such as warm compresses, relaxes the muscles, improves circulation, and reduces pain in the affected areas. It’s beneficial for chronic pain and stiffness and is best used for ongoing pain.

Alternatively, cold therapy, like ice packs, reduces inflammation, swelling, and pain by numbing the area and reducing blood flow. Cold therapy is more helpful for acute injuries that have come on suddenly and need immediate care. Both heat and cold therapy should be used for 15-20 minutes at a time, with breaks, and a healthcare professional should be consulted for guidance.


Over-the-counter medications such as NSAIDs can be effective at temporarily relieving the pain and inflammation caused by thoracic spine sprains. We have a detailed article explaining all about NSAIDs, how they work, and potential side effects here. It’s important to discuss pharmacological pain management options with your doctor.

Physical Therapy

Regular practice of physical therapy and the associated strength and conditioning exercises can help alleviate stiffness and discomfort. Strengthening the muscles and ligaments of the thoracic spine will help improve stability, promote proper biomechanics, and reduce the impact of side effects on your day-to-day mobility. 

Additionally, this can reduce the likely hood of the condition worsening. 

Chiropractic Care

Chiropractic care is a non-invasive approach that uses hands-on manipulation techniques to relieve pain and improve mobility in thoracic spinal sprains. Chiropractors perform gentle adjustments to realign the spine, reduce inflammation, and promote natural healing.

Chiropractic care is often used in conjunction with the already-mentioned therapies for best results. It’s important to consult a licensed chiropractor for personalized care based on your condition and needs to help support your recovery.

Regenexx® Treatment – Centeno Schultz Clinic

At the Centeno-Schultz Clinic we are experts in the evaluation and treatment of thoracic spine injuries including sprains.  Spine stability is critical to the health and proper function of the spine.  Treatment options include PRP and bone marrow concentrate.

PRP is rich in growth factors that promote your body’s natural ability to repair itself.  Bone marrow concentrate contains many different cells including stem cells which can aid in the healing of many thoracic spine injuries.

Injection of thoracic spine ligaments are advanced procedures that your PCP or local orthopdic surgeon can not perform.  Why?  The anatomy in the thoracic spine is complex and includes vital structures that include the lungs.  A misplaced needle can cause potentially life threatening complications such as a collapse of a lung.

At the Centeno-Schultz Clinic all injections are performed under x-ray or ultrasound guidance to maximize safety and to ensure that the PRP or bone marrow concentrate is delivered directly into the targeted area.

Sprain Of Thoracic Spine Is A Common And Treatable Condition

Ligaments are thick pieces of connective tissue that connect bone to bone and provide stability.

The thoracic spine is that section of the spine that is below the neck and above the neck.  It is also referred to as mid back. Ligament injuries are graded based upon the severity of the injury: Grade 1-3. There are 9 important ligaments in the thoracic spine that provide stability and protection for the spine. These ligaments are susceptible to injury and degeneration.

The most common symptoms of thoracic spine sprain include pain, stiffness, muscle spasms and difficulty with breathing.  Trauma, repetitive activities, and degenerative disc disease are the most common causes of thoracic spine sprains.  Conservative treatment options include heat, anti-inflammatory agents, physical therapy, and chiropractic care.

When pain persists and conservative therapy fails to provide significant benefit, PRP and bone marrow concentrate are regenerative treatment options.   They allow patients to use their own cells to aid in the healing process and avoid dependence on potentially addictive narcotics or high-risk surgery.

The Centeno-Schultz Clinic are experts in the evaluation and management of thoracic spine injuries.  When pain becomes persistent it is a warning signal that you have a problem that warrants further evaluation.  Ignoring the problem in many cases can result in a smaller problem morphing into a much larger problem.  This in turn can limit simple treatment options and outcomes.

If you or a loved one suffers from thoracic pain, it may be arising from a thoracic spine sprain. Stop treating the symptoms and schedule a consultation with the experts at the Centeno-Schultz Clinic.  Securing an accurate diagnosis is critical as it will allow for the best treatment plan to be implemented.  Anything less is shooting in the dark.

Prolotherapy For Thoracic Pain

Prolotherapy is an injection based regenerative therapy used in the treatment of ligament, tendon, muscle and spine injuries. It is minimally invasive and involves the injection of an irritant such as dextrose into the damaged or painful area. The injected irritant stimulates a delayed or frozen healing cycle thereby increasing blood flow and tissue healing. The thoracic spine is that section of the spine that is below the neck and above the low back. It is also referred to as the mid back. It has multiple components that include: Vertebral Bodies: Boney building blocks that stack one upon another…

Read More About Prolotherapy For Thoracic Pain

Prolotherapy Injections

It has been successful in the treatment of many disorders including neck, shoulder, knee, and ankle pain. Dr. Centeno recently published an article in The Journal of Prolotherapy in which he discusses the use of x-ray guidance with prolotherapy. This ensures that the injection is in the correct place to maximize clinical results. Dr. Centeno discusses the use of prolotherapy for the treatment of neck, knee, sacroiliac joint, ankle, ischial tuberosity, and shoulder pain. At the Centeno-Schultz Clinic x-ray guided prolotherapy is just one of the therapies utilized in the successful treatment of pain. Regenerative injection therapy (RIT) or prolotherapy…

Read More About Prolotherapy Injections

PRP Injections

PRP is short for platelet-rich plasma, and it is autologous blood with concentrations of platelets above baseline values. The potential benefit of platelet-rich plasma has received considerable interest due to the appeal of a simple, safe, and minimally invasive method of applying growth factors. PRP treatments are a form of regenerative medicine that utilizes the blood healing factors to help the body repair itself by means of injecting PRP into the damaged tissue. In regenerative orthopedics, it is typically used for the treatment of muscle strains, tears, ligament and tendon tears, minor arthritis, and joint instability. There have been more than 30 randomized controlled trials of PRP…

Read More About PRP Injections

Thoracic Spine Physician and Expert

John Schultz, MD

John R. Schultz M.D. is a national expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate and PRP for orthopedic injuries. He is board certified in Anesthesiology and Pain Medicine and underwent fellowship training. Dr. Schultz has extensive experience with same day as well as culture expanded bone marrow concentrate and sees patients at the CSC Broomfield, Colorado Clinic, as well the Regenexx Clinic in Grand Cayman. Dr. Schultz emphasis is on the evaluation and treatment of thoracic and cervical disc, facet, nerve, and ligament injuries including the non-surgical treatment of Craniocervical instability (CCI).

More Resources for Thoracic Spine Sprain

The Spine Owner’s Manual: How to Avoid Back Pain & Life-Altering Surgery

This e-book from Dr. Chris Centeno focuses on the spine and how it functions within the human musculoskeletal system and the body as a whole. Everything in our bodies works together like a well-tuned symphony to support our well-being, and a strong spine (including all of its component parts, such as spinal nerves, ligaments, muscles, etc.) is critical to complete health.

Using the Regenexx SANS approach, The Spine Owner’s Manual provides a series of tests and clearly defined exercises that you can do on your own to measure and monitor your own spinal health. These musculoskeletal tests will allow you to monitor where your own body might be struggling to maintain proper stability, articulation, symmetry, and neuromuscular function.

Relevant Articles

  • Understanding the Role Of The Thoracic Spine Muscles

    The thoracic spine plays a critical role in the stability and mobility of the upper body. Comprised of twelve vertebrae and an intricate network of muscles and ligaments, it serves as a central pillar supporting the structure and movement of the body. Understanding the role and function of thoracic spine muscles is pivotal for anyone…

  • Thoracic Spine MRI: What is It?

     Are you getting an MRI of your thoracic spine?  Get the help you need with the Centeno-Schultz Clinic.  Learn what you need to know about this exam. What to expect on your thoracic spine MRI scan? What exactly is an MRI of the thoracic spine?  How does an MRI work? What are the risks and…

  • Could The Anterior Longitudinal Ligament Be Causing Your Neck Pain?

    The neck pain is unrelenting, and it all started after being rear-ended at a stoplight. Spine X-rays demonstrated some abnormal movement of the spinal bones. Both conservative care and medications have failed. Your doctor thinks you have injured a spinal ligament. What is the anterior longitudinal ligament? What is its role? What ligaments are injured…

  • Neck Pain but Your Imaging Is NORMAL? An Important Read…

    Do you have neck pain but your imaging is read as normal? This is unfortunately a common problem and prevents many patients from getting the care they need for these serious cervical injuries. Dr. Markle explains using two recent case studies of patients he has treated.

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  1. Grassi A, Quaglia A, Canata GL, Zaffagnini S. An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints. 2016 Jun 13;4(1):39-46. doi: 10.11138/jts/2016.4.1.039. PMID: 27386446; PMCID: PMC4914372.
  2. Bizdikian AJ, El Rachkidi R. Posterior Ligamentous Complex Injuries of the Thoracolumbar Spine: Importance and Surgical Implications. Cureus. 2021 Oct 14;13(10):e18774. doi: 10.7759/cureus.18774. PMID: 34796064; PMCID: PMC8590454.

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