Most low back pain is caused by muscle contractures, trauma or spinal deformities, but about 1 in 10 patients have it as a result of a systemic disease. Low back pain can occur anywhere in the back from the neck to the lumbar region and may be in a small area or spread over a large area. Low back pain disorders are not only present in the mental but also widespread in the physical workforce and are the most common clinical condition. Low back pain has become a chronic disease that is difficult to treat in modern society because of the difficulty of treatment, long treatment course and easy recurrence, which seriously affects people’s quality of life. Some data show that about 15-20% of people experience thoracic back pain at least once in their lifetime, and the incidence is higher in adolescents, especially in women, probably due to poor posture during the development of the thoracic spine. When it comes to thoracic back pain, it is important to introduce the thoracic spine, which is composed of 12 vertebrae, each of which is articulated with a pair of ribs that form a joint with each other. Compared to the cervical and lumbar vertebrae, the thoracic vertebrae have very little mobility and their main function is to form the thoracic cavity together with the ribs to protect internal organs such as the heart and lungs, as well as an important function of connecting the cervical and lumbar vertebrae to keep the thoracic back straight. Aging of the intervertebral disc is the cause of back pain The nucleus pulposus, a soft tissue located in the center of the disc, is surrounded by a whorled cartilaginous fibrous ring, the outer part of which is the anterior longitudinal ligament at the front and the posterior longitudinal ligament at the back, which plays an auxiliary role. The ring of fibers contains strong collagen fibers, a very elastic tissue, and the nucleus pulposus, located in the center, is gelatinous and contains much water. As a result, the intervertebral discs are elastic and absorb and moderate the impact on the spine. The tires of the car can support the operation of the extremely heavy car body, but also play the role of a soft cushion to avoid the impact brought about by the roughness of the road directly to the car body. This is because the tires are made of elastic-rich rubber, which is filled with air. The same applies to the intervertebral disc, where the elastic fibrous ring tissue and the water in the nucleus pulposus act as a cushion. However, the water in the nucleus pulposus gradually decreases from about 20 years of age, and after 30 years of age, the water in the annulus fibrosus also gradually decreases, and the disc begins to age at the earliest and gradually loses its elasticity. As a result, the cushion function is weakened and cannot cushion the impact on the lumbar spine, making it easy to produce pain. Insufficient muscle strength is also a cause of lumbar pain. The movement of the upper body is of course not supported only by the vertebrae and intervertebral discs, but also by the ligaments and muscles that connect the bones to each other. Among them, muscle elongation or contraction, in addition to joint flexion and extension, also plays an important role in fixing the spine, which is made up of many bones and bones linked to the spine can be straight and upright, because of the muscle tension around it. For example, the lumbaris major muscle on both sides of the spine, the lumbar quadratus muscle on the inner side of the waist, the rectus abdominis muscle on the ventral side, the external abdominal oblique muscle, and the internal abdominal oblique muscle are all related to the stability and movement of the spine. However, when the muscles age, muscle strength also becomes weaker, and insufficient exercise can also lead to a decrease in muscle strength. The muscle strength that supports the spine deteriorates and naturally becomes the cause of back pain. In order to fix the spine, back muscle strength and abdominal muscle strength must be well balanced. However, because of the deterioration of the abdominal muscle strength, this balance is disrupted and, as a result, low back pain occurs. This is a very common condition. However, although they are all called vertebrae, not all parts are the same size. The cervical vertebrae only need to support the weight of the head, so the vertebrae are thin, while the lumbar vertebrae, which carry the full weight of the upper body, are large and strong enough to carry the weight of the upper body. On the other hand, the fact that the lumbar spine has to bear heavy pressure also means that this part is vulnerable to injury. In fact, it is the lowermost part of the lumbar spine, the 5th lumbar vertebra and the sacrum, that is most susceptible to low back pain. The reason why the lumbar back is prone to disease When humans are upright, from the side, the spine is not a vertical straight line to support the body, but a slight S-shaped bend above the pelvis, and the pelvis is also slightly tilted relative to the ground, and in this state the body is subject to the force of forward movement, which overloads the lumbar region. On the other hand, the neck has to support the 4-5 kg head, but also to maintain a high degree of flexibility to complete the head turn, head lift, head down and other movements, resulting in an increased burden on the neck. Supporting the head and neck is the back of the shoulders, for the shoulders, hanging two arms that account for 1/8 of the weight, two arms in carrying heavy objects, all the burden falls on the back of the shoulders. From this, it can be seen that when humans walk upright, in order to survive, they have to carry heavy objects or carry things, etc., and have various skills, therefore, with the spine as the center, the neck and waist are often overburdened, plus the structure of the low back is precise, ingenious and complex, so it is easy to be damaged and get sick. Low back pain arises from everyday life Posture is the most important factor in determining the health of the low back. Wrong posture is the main cause of low back pathology, which usually leads to premature irreversible degeneration of the bones and joints of the spine, causes muscle imbalance and tension, and also makes the ligaments loose or too tense, all of which can cause low back pain. Therefore, in daily life, poor posture, such as: incorrect sitting, standing, walking and sleeping posture, prolonged reading, writing, watching TV, surfing the Internet, prolonged sitting in the office, incorrect handling of objects, prolonged driving, low work surface height in home life, trivial household chores and sports injuries, etc. can all cause or aggravate low back pain. clinical symptoms. In the early stages of spondylosis, there are no obvious signs of neurological damage. Warning signs Although most thoracic back pain resolves on its own, it is advisable to consult a physician if the following conditions occur 1. a recent history of infection; 2. elevated body temperature; 3. inexplicable weight loss; 4. unrelieved by rest; 5. morning stiffness. You should seek emergency medical attention when the following conditions occur 1. weakness or numbness; 2. urinary or fecal disorders or incontinence; 3. history of tumor; 4. recent trauma, such as a fall from a height or a car accident injury. Examination If the chest and back pain persists without relief, it is recommended to improve the following related examinations: chest X-ray, thoracic spine MRI, blood routine, tumor markers and other examinations, please follow the doctor’s arrangement for details. Treatment If fracture, infection, tumor and other diseases are ruled out after examination, the following treatment methods can be used to relieve pain. 1. non-steroidal anti-inflammatory drugs (such as ibuprofen, etc.); 2. epidural injection to eliminate perineural inflammation; 3. injection of small joints of the thoracic spine to eliminate inflammation of small joints and their posterior branches of the thoracic nerve. In addition, physical therapy, exercise and massage can be used to improve symptoms and reduce recurrence.