All About Upper Back Pain - Spine-health

These large upper back muscles are prone to developing strains or tightness that can be painful and difficult to alleviate. Muscular irritation in the upper ... Skiptomaincontent YouarehereConditionsUpperBackPain AllAboutUpperBackPain   share   pinit   Newsletters ByJ.TalbotSellers,DO  |  PeerReviewed Thethoracicspine—alsoreferredtoastheupperbackormiddleback—isdesignedforstabilitytoanchortheribcageandprotectvitalinternalorganswithinthechest. Save Thecervicalregionofthespineisthemostflexible,followedbythelumbarregion.Thethoracicspine,however,hasamorelimitedrangeofmotionasitisanchoredbytheribcage. Comparedtotheneck(cervicalspine)andlowerback(lumbarspine),theupperbackisremarkablyresistanttoinjuryandpain.Whenupperbackpaindoesoccur,itistypicallyduetolong-termpoorpostureoraninjurythatoverpowersthethoracicspine’ssturdiness. WatchSpineAnatomyOverviewVideo Thisarticleexploresvarioussymptomsofupperbackpain,potentialcauses,andmoderndiagnosticmethodsandtreatments. advertisement TheThoracicSpineandWhatCanGoWrong ThoracicSpineAnatomyandUpperBackPain Save Figure1:Thoracicregionofthespine.ReadThoracicSpineAnatomyandUpperBackPain Infographic: UpperBackPain (largerview) Save Reference:UpperBackPain Thethoracicspinestartsbeneaththeneckandiscomprisedof12vertebrae,labeledT1throughT12,whichgodownthebackofthetorso(Figure1).Unlikethecervicalspineandlumbarspine,thethoracicspineisrelativelyimmobilebecauseeachofitsvertebraeareconnectedtoapairofribs(oneoneachside),whichalongwiththesternumatthefrontofthechestcombinetoformtheribcage. SeeThoracicVertebraeandtheRibCage Iftheupperbackbecomespainful,itistypicallyforoneofthefollowingtworeasons: Muscularirritation.Theshouldergirdleattachesbylargemusclestothescapula(theshoulderblade)andthebackoftheribcage.Theselargeupperbackmusclesarepronetodevelopingstrainsortightnessthatcanbepainfulanddifficulttoalleviate.Muscularirritationintheupperbackistypicallyduetoeitherde-conditioning(lackofstrength)oroveruseinjuries(suchasrepetitivemotions). SeeUpperBackPainfromIntercostalMuscleStrain Jointdysfunction.Eitherfromasuddeninjuryornaturaldegenerationduetoaging,jointsinthethoracicspinecanbecomedysfunctionalandpainful.Someexamplescouldincludeafacetjoint’scartilageorjointcapsuletearing Ifupperbackpainbecomesbadenoughtolimitactivities,itusuallyfeelslikeasharp,burningpainlocalizedtoonespotorageneralachinessthatcanflareupandpossiblyspreadtotheshoulder,neck,orelsewhere. InThisArticle: AllAboutUpperBackPain UpperBackPainSymptoms DiagnosingUpperBackPain CausesofUpperBackPain EarlyTreatmentsforUpperBackPain MedicalTreatmentsforUpperBackPain CausesofUpperBackPainVideo WatchUpperBackPainVideos TheCourseofUpperBackPain Fewstudieshavebeendonetotrackthefrequencyofupperbackpain.AFrenchstudyofworkersacrossvariousprofessionsfoundabout9%ofmenand17%ofwomenreportedatleastsomeupperbackpain,butotherstudieshavefoundnumbersthatrangelowerandhigher.1,2 Upperbackpaincanappearsuddenly,suchasfromaninjuryorfornoapparentreason.Itcanalsostartgradually,suchasfromsittingwithpoorpostureatwork. Insomecases,upperbackpaincanbemanagedwithself-care,includingrest,adjustingposture,orapplyingheatorice.Ifthepainpersists,othertreatmentsmaybeneeded,suchasmedication,physicaltherapy,ormanualmanipulation. Duetoacombinationofthethoracicspine’srigidityandcloseproximitytotheheart,lungs,andothervitalorgans,surgeryislesslikelytobeperformedonthethoracicspinecomparedtothecervicalandlumbarspines.OnlyinrarecaseswillanMRIorCTscanfindananatomicprobleminthethoracicspinethatisamenabletoanysortofsurgicalsolutionforupperbackpain. advertisement WhenUpperBackPainIsSerious Mostcasesofupperbackpainarenotduetoaseriousunderlyingcause,butrarecasesmaybecausedbyaprogressinginfectionorillness,orfromspinalinstabilitythathasstartedtoaffectanerverootoreventhespinalcord.Insuchcases,itisimportanttoseekmedicaltreatmentimmediatelytoreducetheriskoftheproblembecomingworse. SeeThoracicSpinalNerves Symptomsthatcouldindicateaseriousunderlyingcauseofupperbackpainincluderadiatingpainorpins-and-needlestinglinginthechestorabdomen,feverorchills,reducedcoordination,problemswalking,orsevereheadache.Inaddition,upperbackpainthatfollowsahigh-impactevent,suchasanautoaccidentorfallfromaladder,shouldbeevaluatedbyadoctor. SeeWhenBackPainMayBeaMedicalEmergency References 1.FouquetN,BodinJ,DescathaA,etal.Prevalenceofthoracicspinepaininasurveillancenetwork.OccupMed(Lond).2015;65(2):122-5.2.BriggsAM,SmithAJ,StrakerLM,BraggeP.Thoracicspinepaininthegeneralpopulation:prevalence,incidenceandassociatedfactorsinchildren,adolescentsandadults.Asystematicreview.BMCMusculoskeletDisord.2009;10:77. 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