What is upper back pain?

Pain in the upper back is usually the result of poor posture, muscle overuse, or injury. Treatment may include home remedies, such as rest and gentle exercises, or possibly seeing a physical therapist.  The upper back is the area between the base of the neck and the bottom of the rib cage. There are 12 bones that make up the upper back, which call the thoracic spine. Most people describe upper back pain as a burning or pulling sensation in one place, which may be misplace from injury or strain.

 

Common causes of upper back pain

Though it is less common than lower back pain or neck pain, a study posted to Occupational Medicine indicated that 1 in 10 men and 1 in 5 women might suffer from upper back pain. Doctors call upper back pain thoracic spine pain or TSP. Common causes include the following:

Muscle de-conditioning and poor posture

People can condition their muscles over time to be stronger or more enduring through exercises and weight training. The reverse is also true. Humans may de-condition their muscles over time by not using them correctly. In some muscles, including back muscles, de-conditioning is as easy as sitting at a desk with incorrect posture for too long. A person may do this while at work.

 

Slouching in a chair over a desk may cause a loss of strength in the muscles. Over time, the weakening of muscles may lead to pain in the area as they experience strains or irritation.

When a person slouches, pressure from gravity and the body itself pushes on the spine, neck, discs, and ligaments. Over time, this pressure can lead to pain and other complications. It is possible to condition the muscles to be stronger and more durable in most cases. This process starts with correcting the posture while sitting, and taking regular breaks from the desk to move around and stretch. Exercises may also improve strength in the back, using a standing desk can help, too.

Conditioning the muscle requires patience, however, anyone with chronic upper back pain from weak muscles might benefit from seeing a physical therapist to find an exercise routine for their specific needs.

 Muscle overuse

Overusing back muscles is another common cause of upper back pain. This typically occurs due to repeating the same motions over time. This can be a cause of muscle strain, tightness, irritation. The classic example of how this occurs is a pitcher in baseball, who does a similar motion every time they pitch, which can often take a toll on their shoulder.

Other repetitive activities may cause similar pain. Someone who has to make the same motion all day, or lifts things above their head throughout the day, for example, may start to experience muscle irritation, tightness, or strain. This could turn into chronic pain if they ignore these signs.

 

Treatment for muscle overuse typically begins with resting the area, as well as using heat or ice packs to promote blood circulation to the muscle tissues. It may help to find ways to avoid the repeated motion where possible or to take breaks between activities.  A physical therapist may recommend exercises to promote flexibility and strength in the area.

Traumatic injury

A traumatic injury can also lead to back pain. This may be the result of situations that include car accidents, slipping and falling, work-related, accidents, lifting incorrectly, working out too hard. The injury is sometimes obvious, and pain appears just after the incident. At other times, the pain may not develop until later or the next day.

Traumatic injuries can be severe, an issues from injuries, for example, fractured vertebrae, put a person at risk of lasting complications, including chronic pain, nerve damage, and paralysis.

A doctor should look at all potential back injuries as it is vital that they heal properly to avoid long-term pain. A doctor may refer the person to a physiologist or physical therapist to help muscle injuries heal properly. Severe injuries may require surgery.

Herniated disc

Discs in the spine prevent the vertebrae from rubbing against each other.

Herniated discs are more common in the lower back but may sometimes happen in the upper back too. Discs are the soft, rubbery cushions between each vertebra. Herniated discs occur when a piece of this cushion pokes through and puts pressure on the spine.

Even a small amount of pressure can result in significant pain in the middle of the back, as well as other symptoms, including numbness or weakness in the arms or legs. Most people do not need surgery for herniated discs and will recover with rest or by taking anti-inflammatory medications or therapeutic massage.

Pinched nerve

A herniated disc can slip far enough out that it compresses the nearby nerve. A pinched nerve in the middle back may cause numbness and pain in the arms or legs, problems with controlling urination, weakness or loss of control in the legs

When a pinched nerve comes from a herniated disc, the treatment is similar to treating the herniated disc. A pinched nerve does not usually need surgery, though doctors may recommend spinal steroid injections in some cases.

Osteoarthritis

The source of back pain is sometimes not the muscles, but a problem in the bones and joints. The cartilage that cushions and protects the bones may wear down as a person ages. The term for this is osteoarthritis. It is the most common form of arthritis among older adults.

 

According to the United States National Institute on Aging. Osteoarthritis may eventually lead to cartilage between the bones completely wearing away, causing the bones to rub together. This can also put pressure on the nerves in the spine, causing numbness or tingling in the arms and legs. Treatment typically focuses on managing pain and keeping the joints functioning.

Myofascial pain

Pain may also stem from problems in the connective tissue in the back, which doctors call the fascia. Myofascial pain may begin after an injury or overuse, but chronic myofascial pain may last long after the initial injury. It is still uncertain why myofascial pain continues in some cases. Doctors may recommend physical therapy and myofascial release therapy to enable a person to work the fascia and relieve the pain.

Spinal infection

In some cases, surgery may be necessary to treat a spinal infection. Rarely, an infection may be the cause of upper back pain. A spinal epidural abscess is a collection of germs and pus that form between the spinal cord and bones of the spine.

The abscess can grow and swell, leading to pain. Early diagnosis is critical, and doctors will treat a spinal abscess quickly to avoid serious complications. Antibiotics may help, and surgery may be necessary to clear the abscess and reduce the risk of complications.

 

Other conditions

Specific conditions affecting the spine or muscles may also lead to upper back pain. These include: scoliosis, fibromyalgia, spinal deformity, problematic kyphosis. Treatment for each condition varies and will have varying degrees of success.