Question
Dr. Gillman, I'd like your opinion.  
The first time I had a back spasm I was 15.  I'd bent over getting into a lifeguard chair and couldn't stand back up.  My PCP gave me muscle relaxers and I didn't have another problem until 8 years later when I reached for a bottle on a shelf and felt a catch around mid back.  When I bent over to stretch, I couldn't stand back up.  I saw a DC this time and she adjusted me, did some stim and it was fine after for 7yrs.  
Since then, my back always aches just below my shoulder blades.  I can adjust simply by flexing to get 3-4 pops in the area.  Most recently I've lost 50+ lbs and have been exercising a lot.  After I've done any kind of front weighted lift, the next day my back goes out with a spasm from something like lifting a child.  
My DC helps, but since it's recurring, I went to see a Orthopedic/SM specialist.  His office physical therapist "pressed" on the "spines" of the vertebrae (sideways)checking for movement and T7 moved, which I could feel.  That is right above around where the spasms occur.  Have you ever heard of anything like this before?  When my erector spinaes are not spasming, they are like steel cables, but don't hurt.
Any insight would be greatly appreciated.
Thanks!

Answer
Rob,

THis is an interesting and curious situation.   First off, congrats on dropping 50 pounds!  That's no easy task.   T7 is among the stiffest part of the thoracic spine, so it is odd that you and the PT can feel it moving around.   But I wonder...do your other vertebrae move around like this, too?  Also, the middle thoracic region will cause pain in the middle back and also can refer into the chest or upper abdomen, so the movement as you described of "lifting a child" will surely put a stress on this region.  And if a joint system goes foul in this region it can cause searing pain and spasm.  I, too, have experienced this...   The odds of T7 being unstable is slight - and by unstable I mean loose, with lax ligaments that fail to hold the joint complex together.  Again, this is supposed to be a stiff region of the spine.   I wonder if you have an underlying scoliosis in this region that places undue stress on the joints and fascia.  If so, that could explain the problem.   I would suggest getting a simple xray of the thoracic spine, in a standing/weight-bearing position to see if there is any signficant curvature or some other underlying arthritic process or anatomic barrier.  One of the ways to determine instability is to take the xrays (front to back) with your torso loaded up.  This would mean holding a barbell with about 100 pounds (if you can handle that) across your shoulders and taking the xray.  Loaded and unloaded xray is used to determine instability in the lower lumbar spine, and while I'm suggesting it for your thoracic spine, I've never seen it done and cannot state that it is a valid approach or that any findings would be clinically meaningful.  Nevertheless, based on its feasability in the lumbar spine, it's an option if nothing else provides clues.  Lastly, one of the ways to understand a condition is to treat it when it's flared up and when you can provoke and alleviate the pain with various body posturs.  When this happens, the DC or PT with good soft tissue treatment skills can treat specific tissues as you provoke the pain to see if they can hit a bullseye: in this case, a tissue or joint location that takes the pain away so that you cannot provoke it any longer.  Other ways to tinker with this would be to do muscular co-contraction of different muscle groups when you are in a pain-provoking position to see if that takes the pain away.  Information gained from this would help in determining which exercises to focus on.    So, that's all the insight I have on this.   I hope it was helpful.  

'Regards,

Dr. G