The thoracic spine (upper back) serves as an anchoring point for your ribs and plays an important role in trunk range of motion and organ protection. There are many ways to injure the thoracic spine, with blunt trauma, hyperextension, and forced rotation being the most common. Pushing and pulling activities like shovelling will typically worsen thoracic symptoms. Discomfort with deep breathing or arm elevation will tend to aggravate a rib dysfunction, while pain with coughing and sneezing could indicate a problem with the rib joint. Osteoarthritic pain in the thoracic spine gradually worsens throughout the day.