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Thoracic Facet Joint Strain

  For an Illustrated Exercise Guide and Exercise Video's for Thoracic Facet Joint Strain click here: 


Thoracic Facet Joint Strain - Why does this happen?

The thoracic spine is made up of 12 vertebrae stacked on top of each other.  The vertebrae have small joints on either side, the facet joints, which allow movement between the vertebrae.  There is a fibrous disc between each vertebrae which act as a shock absorber and allow the spine to be more flexible.  Nerves pass from the spinal cord to the abdomen and chest through a narrow space between vertebrae.



Thoracic Facet Joint Strain occurs when the small joints between the vertebrae, the facet joints, are overloaded or overstretched as a result of poor posture or an injury caused by the sudden movement of the joint.  The facet joints become inflamed and the muscles on either side of the spine go into spasm causing the back to become stiff and painful.  In severe cases the nerves can become irritated which may cause pain around the side of the chest.

What are the symptoms?
  • Pain in the mid back, between the shoulder blades.
  • Pain may radiate into the chest , ribs or occasionally into the arm.
  • Restricted movement in the back, particularly in the morning and after periods of rest.
  • Disturbed sleep due to pain.
  • Headaches in the back of the head.
Diagnosing Thoracic Facet Joint Strain

Your GP or Physiotherapist can usually diagnose Thoracic Facet Joint Strain by simply by examining your back and hearing where the pain is and how it started.


X-rays and other tests are not usually necessary

What is the treatment?

A Thoracic Facet joint Strain will usually recover with some simple changes to activity and exercise. Stay active but balance rest periods with activity. By trying to avoid or reduce the activity which causes the pain, you will allow the damaged tissue time to recover and heal. 


To help reduce the symptoms a ‘hot pack’ can be placed on the painful area for 15 - 20 minutes twice a day.  Wrap the 'hot pack’ in a towel before placing on the painful area to ensure you do not burn the skin.



During the initial painful stages it is important to manage the pain.
Painkillers and anti-inflammatory medications  -  These may be prescribed by your GP if the pain is costant.  This is a temporary measure to break the pain cycle, but can continue as required.
Exercise  -  Exercise is important to help regain full back movement in the early stages. Once the pain has settled it is important to strengthen the surrounding muscles and work on your balance to help prevent reoccurrence  Click here for a list of exercises suitable for Thoracic Facet Joint Strain

Posture  -   It is important to reduce the stress on the joints as they heal by ensuring you have a good posture during day to day activities.  Check your sitting posture, particularly when using a computer or reading you should ensure your ears are in line with your shoulders and hips.  Placing a cushion or rolled up towel behind your lower back may help improve your posture and reduce the stress on the spine.


Physiotherapy -   If exercise alone does not improve symptoms then physiotherapy treatment may be required.  A physiotherapist can use specific treatments including, ultrasound, deep friction, massage, interferential, acupuncture or taping to help relieve pain and aid recovery.  Click here for more information about Physiotherapy.


Injections  -  In some cases your GP or Consultant may recommend an injection. These can be used to reduce inflammation and pain when the symptoms are severe and constant.  This is not a 'cure' and it is important to follow the exercises and modify activities.  A 'Cortisone Injection' can help reduce inflammation in the joints.


Surgery  -  This is not common for a Lumbar Facet Joint Strain. In some cases when symptoms are persistent surgery may be considered. 

Red Flags for Thoracic Pain

(Red Flags are warning signs that further investigation may be required and you should seek urgent medical attention)


Severe constant back pain which cannot be relieved by a change of position.

Back Pain following a major trauma.

History of cancer.

Unexplained weight loss.


Remember an important part of treatment for Thoracic Facet Joint Strain are your home exercises and modifying activities.