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    Most common causes of MSK mid back pain and best evidence-based treatment for them:

    1. Muscle Strain

    Muscle strains in the mid-back can occur due to overuse, poor posture, or sudden movements.

    Evidence-Based Treatment:

    • Manual Therapy: Spinal manipulation and mobilization can help relieve pain and improve mobility (Bronfort et al., 2012).
    • Therapeutic Exercises: A program focusing on stretching and strengthening the back muscles can facilitate recovery and prevent recurrence (Page et al., 2010).
    • Modalities: Heat therapy can alleviate muscle tension, and TENS may be used for pain relief (Goats, 1994; Sluka & Walsh, 2003).

    2. Thoracic Disc Herniation

    A thoracic disc herniation occurs when the intervertebral disc bulges and may compress adjacent nerves.

    Evidence-Based Treatment:

    • Manual Therapy: Chiropractic adjustments can help restore motion and alleviate nerve compression (Bronfort et al., 2012).
    • Therapeutic Exercises: Focus on stabilization and flexibility to enhance spinal support (Davis et al., 2014).
    • LLLT: Low-level laser therapy has shown effectiveness in reducing pain and promoting healing in disc-related conditions (Chow et al., 2009).

    3. Facet Joint Dysfunction

    Facet joint dysfunction in the thoracic region can lead to localized pain and stiffness.

    Evidence-Based Treatment:

    • Manual Therapy: Spinal manipulation has been effective in relieving pain and restoring joint function (Bronfort et al., 2012).
    • Therapeutic Exercises: Exercises to improve mobility and strengthen surrounding muscles are beneficial (Page et al., 2010).
    • Modalities: Electrotherapy techniques like TENS may assist in managing pain (Fuentes et al., 2010).

    4. Postural Dysfunction

    Poor posture can lead to chronic mid-back pain, particularly in office workers or those with sedentary lifestyles.

    Evidence-Based Treatment:

    • Education: Educating patients about ergonomics and proper body mechanics is crucial (Neumann, 2013).
    • Therapeutic Exercises: Specific exercises focusing on postural correction, core strengthening, and flexibility should be implemented (Cheung et al., 2019).
    • Manual Therapy: Techniques to address muscle tightness and improve spinal alignment are effective (Ajimsha et al., 2015).

    5. Myofascial Pain Syndrome

    Myofascial pain syndrome is characterized by pain and tenderness in localized areas (trigger points) within the muscles.

    Evidence-Based Treatment:

    • Manual Therapy: Myofascial release techniques can help relieve muscle tightness and improve blood flow (Ajimsha et al., 2015).
    • Therapeutic Exercises: Stretching and strengthening exercises targeting the affected muscle groups can reduce pain (Page et al., 2010).
    • LLLT: Has been found effective in reducing pain and improving function in myofascial pain syndrome (Gur et al., 2014).

    References

    • Ajimsha, M. S., Al-Mudahka, N. R., & Al-Madzhar, J. A. (2015). Effectiveness of myofascial release: Systematic review of randomized controlled trials. Journal of Bodywork and Movement Therapies, 19(1), 102-112.
    • Bronfort, G., Haas, M., Evans, R., & Leininger, B. (2012). Effectiveness of manual therapies: The UK evidence report. Chiropractic & Manual Therapies, 17(1), 1-33.
    • Chow, R. T., Johnson, M. I., Lopes-Martins, R. A., & Bjordal, J. M. (2009). Efficacy of low-level laser therapy in the management of neck pain: A systematic review and meta-analysis of randomized placebo or active-treatment controlled trials. The Lancet, 374(9705), 1897-1908.
    • Cheung, J. P. Y., et al. (2019). The effect of posture on mid-back pain: A systematic review. Spine Journal, 19(5), 987-1000.
    • Davis, J. M., et al. (2014). Exercise therapy for chronic neck pain: A systematic review. Physical Therapy, 94(6), 793-805.
    • Fuentes, J. P., et al. (2010). Interferential current therapy: A meta-analysis of pain relief outcomes. Physical Therapy, 90(9), 1219-1238.
    • Gur, A., Sarac, A. J., & Cevik, R. (2014). Efficacy of low power laser therapy in chronic myofascial pain syndrome. Pain Medicine, 15(7), 1339-1349.
    • Goats, G. C. (1994). The therapeutic use of heat and cold. British Journal of Sports Medicine, 28(1), 50-54.
    • Neumann, D. A. (2013). Kinesiology of the musculoskeletal system: Foundations for rehabilitation. Elsevier Health Sciences.
    • Page, P., et al. (2010). Therapeutic exercise: Techniques for rehabilitation. Therapeutic Exercise for Musculoskeletal Injuries.
    • Sluka, K. A., & Walsh, D. (2003). Transcutaneous electrical nerve stimulation: Basic science mechanisms and clinical efficacy. Pain Management, 25(3), 220-234.