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This article is a transcribed edited summary of a video Bob and Brad recorded in June of 2023. For the original video go to https://www.youtube.com/watch?v=aJlzbhZEngc
Brad: All right, if you've ever had back pain, mid-back pain, or the thoracic back, the common symptoms are perhaps if you take a deep breath in and it kind of bites right in there, or you turn and twist and you feel that pain, there's a good chance you have a pinched nerve.
Mike: We're going to show you five easy options to help alleviate this pain that has a strong track record with some of our patients.
Brad: That's right. I'd like to show you the likely causes of this pinched nerve or the pinched nerve-like pain you're experiencing. Number one, at every level there is a spinal nerve. Mike is pointing them out right there. Those nerves could be pinched for several reasons, we're not going to get into all of them.
Brad: Another location of pain source could be the facet joints, there are two facet joints between each vertebra. So you have 12 thoracic joints, that's 24 possibilities.
Brad: And the next thing is where the ribs connect to the transverse process, which is a bone that comes from the vertebrae. And those should be mobile, but they lock up sometimes too, and we need to break those loose and mobilize them.
Mike: So a common reason for a pinched nerve in a thoracic spine area is often from prolonged sitting in a poor posture with rounded down shoulders and putting a lot more pressure on all of those joints we just talked about and the discs. So getting in a correct straight posture can help alleviate some of those symptoms.
Brad: That's right. If you are in this prolonged posture, driving, in your chair, or watching TV, particularly driving like myself and you hit a bumpy road or on my lawnmower and you get this jolting going through your spine, it is terrible on a rounded spine. That can set something off. I've been awakened in the middle of the night with pain and I've got a solution for it and we're going to show you that as well.
Mike: Well, let's get into that.
Brad: The first exercise I like, a lot of people will like, it's not aggressive and it can do the job. We're going to show you two options. One is something you can just use some towels at home. For the other one, you'll need a 36-inch-long six-inch foam roll. You'll see what we're talking about. Thank you, Mike. Now, for the first option you need to take some towels roll them up relatively tight, and then tape them together. Don't worry, you'll use this. So just don't take it apart and wash it. Just keep it for your back stretches. Set it down, so it's about six inches in diameter and you're going to lie on this pretty much right between your shoulder blades. And if you put pillows to rest your head on, it makes it more comfortable and you can relax. You can bring your arms out and go up and down. My shoulders right here, I feel a stretch. And if I wanted more stretch, I would put two weights in my hands, probably one-pound dumbbells or simply a can of soup.
Brad: Make sure you do it on both sides. And that offers a better stretch on my spine and back as well as my pec major muscles. You're going to hang out here for 15 to 30 seconds. You can relax and repeat that. Again, if this creates pain, any sharp pain, it's not right for you. Okay, now, if you happen to have a six-inch foam roller, they work very well. A little more challenging in a way. Make sure you get the one that's soft density and medium works well. You can use the more firm one if you want, it's just not as comfortable. Now, with this, you need to put it on your sacrum, that bone right below your belt line, and then right down, so the roller is between your shoulder blades and you rest your head right on the roller itself. Now, if your head does not touch because you have a tight neck, that may be normal. You want to get a pillow and put that there for comfort so you can relax and you do the same thing. This you can kind of roll back and forth, it can help. If you want to stretch one leg up here just because you want something to do. You can do that with the towel roll as well. Use the weights. Just as I mentioned with the towel roll, it's the same thing except that you have your foam roller. I find a great deal of comfort in my sacrum and my SI joints using this, so I'm getting more than one area. It's a bonus.
Mike: So stretch number two is going to work on your amount of thoracic extension or how far you can bring your back backward. Again, you will need a thick, six-inch towel roll or a foam roller, we'll show both variations. I'm going to place this where it feels comfortable for me. Again, you can use a pillow under your head for some nice support, supporting the head there, and you're going to see what feels comfortable. If I go too low with the towel roll, I feel a lot more lumbar extension. That's not as comfortable. I want to hit that mid-thoracic back area. So I'm going to go and arrange it, where it feels good. You can bring your arms up to your side if you want or keep them in. It's just working on bringing that extension back in your spine.
Brad: That's right. And oftentimes you'll get that cavitation or that crack release. You'll feel that or even hear it. Again, we're going to show with the foam roller. It's a wonderful stretch. This is one of my go-to's.
Mike: So for this one, I'm just kind of sitting in a spot for 10, 30 seconds, and then I might kind of roll up and just get a new spot. Just kind of work through and see what feels good.
Brad: That's right.
Mike: Okay, now we're going to do the same thing but with a foam roller. So for this, you're going to roll. So I'm going to lift my buttock off the ground and I'm going to kind of roll that thoracic spine region roughly to my shoulder blades, to my mid-back. I don't like it once you start getting in the lumbar spine, you'll feel it. If you're getting some headaches or neck discomfort with this, you can put a towel behind your head here and pull it up with your hands to give it some support if you are having some neck pain with this. But this is another way you can just kind of roll into it.
Mike: You can also do what I did before and just kind of lay over it and work on that thoracic extension.
Brad: If you don't have a towel and you have flexible arms, you can simply put your hands behind your head. It gets a stretch into the shoulders and the pecs as well. This is a wonderful stretch. Okay, this next stretch, you're going to need a special tool. It's called the Bob and Brad Posture Pad.
Brad: We developed this specifically for the thoracic spine, for the pinched nerves, as well as helping with that hunch back or that neck hump from head forward posture that people get stuck in after they've been this way for several years. We'll show you how you use it. It's got a nice radius on one side, which is there for a specific reason. These tennis balls are in there for a specific reason. But first, you simply lie on it there. I'm at about T7 right now. I'm going to start low and I'm going to work and you can rock back and forth and you'll find the area that needs the stretch.
Brad: As you can see, I'm supporting my head. You can also take a towel and hold it across your head if that's more comfortable. I always like to do it one way or another, and I'm going to work on it. Now, once you find a spot that needs a stretch, you're going to hang out there for 15 to 30 seconds or longer, whatever you would like. It feels great. It's nice when you can get to that one spot in the corner of the Posture Pad. Now, if you have tight muscles between your shoulder blades, that's the reason we have these tennis balls. And they're not just any tennis ball. The light blue ones have less pressure and the other blue ones have more pressure and all of them have less pressure than a regular tennis ball. But we're going to put those in there and you put them in wherever you would want. I'm going to put the ones with the lower pressure on the top. Now, this is a little more aggressive. You may take a towel and go over it and that's going to go into the knots of the muscle belly between your spine and your shoulder blade on each side and you'll feel it. And what I like to do on this is I like to go forward and backward when I hit that trigger point. The left ball on the top is actually on a trigger point right now. I'm feeling it, I'm working on it. And as I do this, it's much more comfortable. The muscle is releasing and relaxing and that's the point with that.
Brad: Now, Bob uses this regularly. I want to get more aggressive on those trigger points, so I'm going to put the blue ball in the upper corner there and leave the others out to put all the pressure right there on that tight spot. This is just an option and that makes a fairly significant difference and I'm going to work on that. And sometimes that pain is not a pinched nerve. It may be just a knot that is so tight and that muscle's so bound up, that it's burning away and causing pain and this can get rid of it. So the Posture Pad, you go to bobandbrad.com and you can order one of these if you'd like to. Otherwise, we've got the other options that we've already talked about.
Mike: So the next option, again, we're going to work on straightening that spine and fighting against that rounded posture we're in most of the day. So you can do this on a chair, at home, or maybe at your work desk. You can use a ball for a little bit more stretch. You can use a smaller one or a larger one, whatever you have available. So I'm going to put this behind my back in a position that feels good. Kind of going to go mid-back here and then I'm going to lean back into it. And if you have good shoulders, you can lean back into it and then bring your arms up as well. It really opens up everything in the front and gets that spine extending, combating that flexed forward posture we talked about earlier.
Brad: I do want to mention, the ball they use, like Mike said, different sizes, but it needs to be a soft, squishy ball. A basketball would not work. Even a soccer ball is too hard. You need a squishy ball. So if you don't have one, go to the neighbors and see if you can get one from the neighbor kids and then bring it back, of course.
Mike: Do you ever just keep it?
Brad: No. I do want to mention we believe, Mike is the originator of this exercise. How many years ago you were working with patients and showing them this? Like 10 years ago, wasn't it?
Mike: I don't know. I don't remember. It was too long ago. So you can do this stretch throughout the day. You can do repetitions. Say you want to do 10 repetitions and you can hold it for five to 10 seconds each time. If you'd rather just sit here and hold it for 30 seconds to a minute, that's perfectly fine as well. And just do it throughout the day. The whole idea is, if you're sitting hunched over most of the day, take frequent breaks to go and bend your spine in the other direction.
Brad: Most excellent, thank you so much.
Mike: So number five, if you're having referral pain down your arm and into your fingertips, it may be referral pain coming from the lower part of your neck, and Brad is going to show an excellent option for that.
Brad: Right. We're getting out of the lane of the original topic, but it's so closely related to thoracic or mid-back pain, that we're going to address it anyways. So the pain down the arm can be simply numbness, tingling, feeling cold. It's a pinched nerve at the lower neck or upper back. One way you can try to alleviate this, sit up as tall as you can and simply do chin tucks. So you bring your chin in towards your throat, breathe and relax, and see how the pain or the numbness and symptoms in the arm respond.
Brad: If you do this five to 10 times and the symptoms in the hand or the forearm seem to be improving, it's gold, you're going to have progress with this. You may want to put a little overpressure. On the other hand, if the pain, numbness, and tingling down in the arm and you do this and it makes it worse, then you need to stop right there. Now, the next option, if this is getting better, then you can add the neck extension. You take a towel roll and you roll it up, any way you want, so we have some cushion and support on the low neck. Use a firm chair, scoot your bottom back in the chair, and start with a gentle chin tuck. Support with the towel, not pulling hard, just support and look up. And you can bring your hands up to offer a little traction or you can keep them down.
Brad: And what we're looking for is, if you do this and it hurts a little bit, come forward, repeat that a few repetitions. And if it starts to feel better or the pain and the numbness down in the arm and hand are improving, then it's a green light. You continue up to 10 repetitions. And if it feels better in the arm after that, you take a break, come back in an hour, and do the same thing. And you're going to do that every hour as long as symptoms in the arm and the hand improve and are moving upwards towards the shoulder and the neck and eventually your range of motion, less pain, everything will improve and you'll start to go back in a normal supported way until the arm pain, that pinched nerve is then released. It's a little more complicated, so take your time with this one. If it doesn't make the arm better, you stop. It's very clear on that. This can be an excellent option if it works, but only then. Mike, do you have a finishing outro?
Mike: I would say pick which exercise worked for you. There are five and they take a lot of time. Try them all and see what works, and stick to that one for a while to see if it helps.
Brad: That's right. The easiest ones are first, and the harder ones we talked about are a little bit later. Take care. Have a good day.
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