A 50 years old female, Mrs L., presents with middle back pain and left arm pain gradually developed over the weekend without clear mechanism of injury. The only potential reason that she could think of was gardening. She had ongoing back stiffness; otherwise she is normally healthy and active. What could be the cause of her problem?


Clinical examination

Mrs L’s left arm pain is provoked when she is reaching forward. Her left shoulder range of movement is normal. She has reduced neck and middle back range of movement, specifically cervical retraction and thoracic extension.

In neurological examination, Mrs L’s biceps and triceps jerk reflex are normal. Her strength and sensation were also normal. On palpation, her left mid thoracic area is stiff and her arm pain is also provoked.

It appears that Mrs L’s left arm symptom is related to her left thoracic spine.



Mrs L’s left arm symptoms and thoracic spine stiffness are reduced after some thoracic spine joint mobilisation. She was then given some cervical and thoracic mobility exercises to restore her loss of range of movement. Her symptom is almost completely abolished in two weeks.

It is not uncommon that sometimes the arm pain that patient experienced come from a different body part, typically cervical or thoracic spine. A systematic examination procedure will help identifying the source of the symptoms, and aid an appropriate management approach.


If you have any questions regarding suspicious arm pain and need and assessment, please give us a call at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.