A common cause of back pain is rib injury or subluxation. Anatomically speaking, the thoracic spine (middle back) attaches to the ribs. If a blunt force impacts the ribs, even if the force occurs in the front of the body, a symptom may be felt in the middle back because the muscles between the ribs have been irritated or the ribs have collapsed into the level of the spine. This can also happen very easily during a cough or sneeze! The muscles extend from the front of the ribs to the area that attaches to the spine in the middle back, so an uncontrolled cough or sneeze can cause a lot of discomfort in the back. During the examination, it is very common to find a misalignment in the lower back, or in some cases, a misalignment in the lower neck that has contributed to the back pain. Remember, the spine functions as a unit. In the majority of cases, patients will specifically complain of neck or back pain. However, back pain is a reality for some patients and this condition can be treated using chiropractic treatment.