Upper Back Pain – How to Understand Upper Back Pain


It is important to note that the thoracic spine (also called upper back, middle back, or mid-back) is very different in form and function than the cervical spine (neck) or the lumbar spine (lower back). While the neck and lower back are designed to provide us with mobility, the thoracic spine is designed to be very strong and stable to support the weight of the upper body, as well as to anchor the rib cage which provides a cavity to allow the heart and lungs to function and protect them.

Because this section of the spinal column has a great deal of stability and only limited movement, there is generally little risk of injury or degeneration over time in the upper back. this section of the spine does not tend to develop common spinal disorders, such as a herniated disc, spinal stenosis, degenerative disc disease, or spinal instability. These conditions can cause upper back pain but are exceedingly rare in the upper back.

There are three common patterns of back and neck pain that patients typically experience: the upper body, consisting of the neck, upper back, shoulders and arms; the mid back or thoracic region; and the lower body, including the low back, gluteal muscles, hips and legs.

1. Muscular injury or joint disruption (inflammation) – this is the most likely cause of upper back pain. Muscular injury most often occurs in the muscles around the shoulder. The main joint of the shoulder, the glenohumeral joint, connects the upper arm with the torso. This joint is arguably the most manoeuvrable in the whole body – but this feature also makes it the most unstable. To compensate for this vulnerability, the shoulder is made up of a number of strong muscles which support the joint, but allow it a wide degree of movement. These muscles cover the upper back and shoulder, and are very prone to injury which can, in turn, lead to pain.

2. Lifestyle factors – there are certain factors in your life which may contribute to your upper back pain, by repeatedly stressing one area of your back. These factors include:

Not enough exercise, or exercising too much with the wrong technique

Being overweight

Sitting for too long, particularly with incorrect posture

Lifting heavy objects

Continually high levels of stress

Other causes – there is a range of medical conditions which may result in upper back pain.

These conditions are mostly spinal problems, such as

1. Arthritis of the Facet

Joint Arthritis of the facet joint develops slowly over a long period of time. Fractures, torn ligaments and disc degeneration can all cause abnormal movement and alignment placing extra stress on the facet joint. This causes the articular cartilage to wear away, exposing the bone underneath. With bone now rubbing directly against bone, the joint will eventually become arthritic, causing pain and swelling.

2. Bone Spur

A bone spur, also known as an osteophyte, is a bony growth formed around a vertebral body, generally in response to pressure, rubbing or stress that continues over a long period of time. Bone spurs only cause pain if they impinge on nerve roots. The important thing to note here is many individuals have a bone spur but do not carry any symptoms.

3. Coccygeal Pain

Coccygeal pain refers to pain originating from the coccyx, located at the base of the spine. Typically, this type of pain is caused by an injury, such as falling and hitting the tailbone, or excessive sitting.

4. Kyphosis and lordosis

are normal curvatures of the spine. Excessive kyphosis can occur when the spine is bent forward creating a noticeable curve in the upper back, typically the result of years of poor posture or osteoporosis. This type of kyphosis may cause mild to severe back pain, stiffness and fatigue. Excessive lordosis, also know as swayback, occurs when the spine is bent in an inward curve at the lower back. It primarily affects the lumbar spine, creating an exaggerated posture which protrudes the head forward and the buttocks backward. Both of these conditions do not cause pain directly, but may eventually cause vertebrae to impinge on surrounding nerves, resulting in pain.

5. Herniated/Bulging Disc

Herniated discs may occur spontaneously through an injury or heavy strain, or as a preexisting condition. The nucleus of a disc, which acts as a shock absorber located within the area between your spine vertebrae, may rupture and place pressure on the nerves or spinal cord. A bulging disc describes a disc which is protruding, but to a lesser degree then a herniated disc. The important thing to note here is many individuals have a herniated disc but do not carry any symptoms. In fact the majority of these cases require no treatment and even fewer require surgery.

6. Osteoporosis

Osteoporosis is a disease in which bones become fragile and more prone to fractures and bone breakage. The pain and discomfort brought on by osteoporosis can impair a person’s ability to walk unassisted, may cause a loss in height, prolonged disability or deformity. Because osteoporosis does not have any clear symptoms, it’s crucial persons over the age of 50 receive a bone density scan to uncover the disease in its infancy.

7. Pinched Nerve

A pinched nerve causes shooting pain radiating down the arm or leg. This pain can be the result of nerves being impinged by degenerative disc, bulging or herniated disc, bone spur, or arthritis of the facet joint.

8. Degenerative Disc Disease

A degenerative disc can occur through an injury, or simple wear and tear on the spine which comes with age. Degenerative discs are often seen in the general population, and despite the high prevalence, their clinical effect can be unclear.

9. Sciatica

Sciatica, also known as radiculopathy, is a symptom of a problem along the sciatic nerve. A herniated disc or spinal stenosis, for instance, are typical disorders that can cause sciatica, resulting in pain, weakness and numbness down the back of the leg.

10. Spinal Stenosis

Spinal stenosis is a condition that occurs due to a narrowing of the spinal canal. This causes pinching on the nerves, which leads to persistent pain in the low back, buttocks and can also shoot downward into the legs. Those suffering from spinal stenosis may realize a decrease in physical activity or a lack of feeling in the lower extremities when walking.

11. Spinal Cord Tumors

Spinal tumors may arise in any area of the spinal cord. They are extremely rare and, in the early stages, are usually painless. As they grow larger they may potentially cause numbness and pain.

12. Spondylolysis

Spondylosis is a term used to describe a stress fracture or defect in the vertebrae that make up the spinal column. If the stress fracture weakens so much that the vertebrae is unable to maintain its position, it may slip out of place pressing on nerves and causing pain. This condition is known as spondylolisthesis. Though this condition is most commonly found in young athletes involved in sports that require repeated hyperextension of the lower back, it can also present itself in older adults who experience a degeneration in the disc and the facet joints, which can allow slippage even without a fracture. Spondylosis is a common term used to describe arthritis of the spine.

Upper back pain may be described as any form of discomfort and pain experienced on the back side of the chest or the upper abdominal region. The majority of people are likely to experience this pain at some point of their life. Upper back pain may lead to muscle stiffness or tightness and a sharp pain in that region. However, upper back pain is not as common as lower back pain. This is mainly because the thoracic spine makes fewer movements compared to the spine in the lower back. However, this pain should never be overlooked.

Treatments for upper back pain relief

a. Sitting or standing in the right posture

Here’s why–most of our daily activities are done in front of us while seated. How many times a day do you spend driving, writing, typing or eating? Over time, gravity takes over and the shoulders begin to round forward, the chest becomes constricted, the head juts out, and the upper back becomes stretched out or rounded.

Sitting or standing in the wrong posture puts a lot of stress on your upper back. Therefore, you should sit straight or stand tall with the shoulders and stomach pulled in. This helps in supporting the back, relieving the pain and assisting the recovery. Be sure to keep in mind that you should avoid a slouch or slump sitting posture as much as possible.

The result of this posture is tight pectorals, shortened neck and weak upper back muscles. Consequently, smaller muscles that were not originally designed to be ‘postural muscles’ have to kick in and work hard to keep our bodies upright. In addition, certain sports including cycling and running can exacerbate the problem. Pain in the upper back and neck is often just a sign that your muscles are tired of doing a job they weren’t meant for. The solution is to fix the problem, not the symptoms.

In order to combat chronic tension in these areas, you first need to work on stretching the tight structures that prevent you from sitting or standing with ideal alignment. If you strengthen the upper back without stretching the front of the chest, you will just keep falling back into the same faulty posture. Once you open up the chest and stretch out the back of the neck, then it’ll be time to work on strengthening the upper back.

The key is what you do all day. Try these retraining drills slowly. See how you feel the next day, then increase. Use these movements, not as exercises to do 10 times, but to retrain how to stand, sit and move with straighter healthier positioning all day.

If you are experiencing upper back pain, you should take a break and have a good bed rest. However, you should not remain on the bed for too long as this may worsen the problem and lead to more complications such as muscle weakness and stiff joints. Instead, you should try to return to activity gradually and avoid things that may make your situation worse.

b. You should be very careful when lifting objects. If you would like to lift an object, always bend the knees, keep the back straight. Additionally, you should keep the load close to the body when carrying it around.

c. If your upper back pain is due to muscular injury or muscular strain, try applying an ice cold compress to the affected area – a packet of frozen peas being one of the easiest options.

d. Applying a pain relieving gel containing conventional painkillers such as ibuprofen, or a herbal one such as Arnica gel, can help reduce pain and restore movement in your upper back.

e. While some back pain needs medical attention, proper exercise and stretching will help many common problems. Easy exercises can help relieve pain, loosen muscles, increase flexibility and strengthen your backswing, which can generate more power and distance in your shots.

f. Over the counter drugs can turn out to be very helpful in relieving upper back pain. Such drugs include acetaminophen like Tylenol and Nonsteroidal anti-inflammatory medications, including Motrin, Aleve, Advil and aspirin. These drugs help by reducing inflammation and pain of the affected tissues.

g. Fresh fruits, vegetables, eggs, fish and other nutritious foods should be added into diet for eating well is one of the ways to prevent upper back pain. For instance, eating food that is rich in vitamin D, calcium and protein can help in preventing osteoporosis, a condition which predisposes the back to compression and fractures. This in turn helps in preventing upper back pain.

h. Stress reduction is also vital in the fight against upper back pain. This is mainly because stress can worsen the back pain. Therefore, you should carry out relaxation exercises, breathe deeply and meditate regularly to bring your stress levels down.

i. Use a pain diary. With these methods, you should write down how various aspects of your life affect your pain, including sleep patterns, thoughts, medicines and even moods. This is very vital as it will help both the doctor and you to find the best way to manage your pain.

If pain is persistent or recurrent, you may wish to consult a physiotherapist, osteopath, chiropractor or acupuncturist.

Treatment may include joint manipulation and manual movement so that it can be loosened and mobilised. The course of treatment will also include exercises to perform at home and throughout the day.

For all upper back pain, a course of painkillers will be most likely prescribed by your GP, to help ease and comfort and to aid in the course of therapy.

Basically, upper back pain are not a serious disease, but if it happens with other symptoms, it may indicate a sever condition. Therefore, if you experience upper back pain and the following symptoms at the same time, you should seek the attention of a doctor immediately.

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