Upper Back Pain

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Woman clutching painful neck and upper back

The thoracic region of the spine refers to the area between the base of the neck and the bottom of the rib cage. It therefore refers to the upper and middle back area. Many of us think first about lower back pain when the subject of back pain comes up. However, upper back pain is also a serious problem that affects both men and women and causes many lost work days. Although it is less common than lower back pain, upper back pain is also a widespread problem. Occupational Medicine magazine has reported that between 7% and 38% of the working population have experienced thoracic spinal pain. We  will consider below the various causes of this type of pain, and briefly suggest how each cause can be treated.

In what follows, we will frequently refer to spinal vertebrae and discs. Spinal vertebrae are pieces of bone that make up the spine. Spinal discs are pieces of cartilage that are positioned between the vertebrae and act as shock absorbers to cushion the impact between the spinal discs as we walk, run or move around.

Poor Posture

Probably the leading cause of upper back pain is loss of back muscle conditioning due to sitting for long periods in a slouched position. Slouching causes excessive upper body weight to be felt by the upper spine and spinal discs as well as the ligaments in that area. The result can be back pain in the thoracic spinal area.

The solution to this cause of upper back pain is to correct your posture by keeping your upper back and shoulders straight. A posture or upper back brace will be helpful in doing this. This change will by itself help to develop upper back muscles and reduce your propensity to experience pain in this area. You can obtain additional relief by asking a physical therapist to design an exercise program that will further strengthen the upper back muscles.

Overuse Of Upper Back Muscles

Another, often overlooked, cause of upper back pain is repetitive performance of a particular movement.  Over time, this can place excessive stress on upper back muscles and lead to upper back pain. Classic examples of these motions include throwing or pitching actions like those that baseball pitchers perform many hundreds of times in a season. Other examples are repetitive overhead motions such as painting or lifting activity.

The solution to this type of upper back pain often lies in resting the upper back muscles by refraining from overhead, pitching or other activity for a period. You can also supplement this by using hot compresses to improve blood flow through the region.

An exercise program to strengthen the upper back muscles so that they can better withstand repetitive overhead or throwing type activity can also be of benefit. A physical therapist can design such a program for you to follow.

Traumatic Injury

Upper back pain is often the result of a traumatic injury to the upper back. Examples of situations that can lead to such an injury include a motor vehicle accident or a fall. It is usually an easy matter to trace this type of injury back to its cause, as it usually begins right after the occurrence of the event that is the cause.

These types of upper back injury can be very serious and can lead to a great deal of pain. In some cases, the injury can be as serious as cracked or fractured vertebrae and can have very serious long term implications unless properly treated.  If you think that your upper back pain is due to a traumatic injury, you should seek help from a medical professional as soon as possible. If the injury is sufficiently serious, doctors may elect to perform surgery to correct the problem.

Herniated Spinal Discs

Upper back pain can sometimes be a result of herniated spinal discs. This is a condition in which the discs that are located between the spinal vertebrae start to bulge out and exert pressure on the spine. The result can be significant pain in the upper and middle back. You may also experience numbness or weakness in the arms or legs (if the herniated disc presses on a nerve – see below).

This type of problem can usually be resolved by resting the back and taking anti pain and inflammatory medications.

Pinched Nerves

In severe cases, a herniated disc can bulge to an extent that it starts to press on nerves close to the spine. In addition to upper back pain, the result can be weakness or loss of feeling in the legs. You may also experience urinary incontinence.

If your pinched nerve is the result of a herniated disc, correcting the latter will usually eliminate the pinched nerve also. In severe cases, your doctor may suggest spinal steroid injections as an additional measure.

Spinal Osteoarthritis

Your upper back pain may be the result of deterioration of cartilage between spinal discs that causes them to come into direct contact with each other. The resulting pain will tend to increase when you are physically active (walking, running, etc.) but will recede when you are stationary or resting. Pain will also be present for a period after you awake in the morning and start to move around.

As with other forms of osteoarthritis, there is no cure for this condition. Instead, your doctor will focus on reducing your pain and discomfort. Moist heat packs have proven particularly effective in reducing arthritic pain. Over the counter anti pain medication such as Tylenol will also be useful.

Other Causes Of Upper Back Pain

We have covered the most frequent causes of upper back pain above. Your pain may be due to other less commonly experienced causes, such as spinal infections or even cancer. As a result, we suggest that you consult with your doctors whenever you start to experience persisitent upper back pain. They will be able to help you determine the cause and formulate a treatment plan.

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