What Is the Upper Back FROM A PHYSIOLOGY VIEWPOINT and What Does It Do?
Start with an anatomy class if you want to understand your upper back discomfort.
Discomfort in the upper and/or middle back is less prevalent than pain in the lower or upper back. According to a 2015 Mayo Clinic analysis of research, roughly a third of persons have lower back or neck discomfort (a little higher for lower back, a bit lower for neck), whereas fewer than a fifth experience upper back pain.
The area below the cervical spine (neck) and above the low back is the upper back (lumbar spine). The thoracic spine is the most stable section of the spine, located in the upper back. The spine’s attachments to the ribs restrict the upper back range of motion (rib cage).
Consider your spine to be a tree trunk. It keeps you on your feet. It joins the various elements of your bones. It bears the brunt of your upper body’s weight.
Because that’s such a big task, the spine distributes part of the physical strain with adjacent muscles, such as:
Trapezius: Located near your shoulder blade, this muscle aids in standing and throwing.
Latissimus dorsi: A lower back muscle that aids in arm mobility and respiration.
Rhomboids: Adjacent to the trapezius, these muscles stabilize your shoulders and aid in pulling.
One of these muscles was likely damaged if you hurt your upper or mid-back while performing yard work or playing tennis. “A basic musculoskeletal strain is the most prevalent reason we encounter clients with upper back discomfort,” explains Reginald Knight, MD, Director of Bassett Spine Care Institute in Cooperstown, NY.
Spinal cord damage is less prevalent. However, it is conceivable, particularly in those over 65, due to any age group’s acute injury or osteoporosis.
Your spine is made up of a long column of bones (vertebrae) divided by shock-absorbing discs. The discs have a cartilage shell and a gel-like center and are stiff but not solid. The spinal column protects the spinal cord, which contains nerves that transmit information from the brain to different body regions. (The nerves protrude from the gaps between the vertebrae as well.)
Although you may conceive of your spine as a single long structure, it is divided into three sections:
- The cervical spine (neck)
- Thoracic spine (upper and middle back)
- Lumbar spine (lower back) (low back)
- The thoracic spine moves in a completely different way than the cervical and lumbar spines. It doesn’t move at all. The thoracic spine is robust and sturdy since it is attached to your ribs and sternum, making it less prone to damage. One of the reasons for this is that upper back discomfort is frequently caused by muscles rather than the spine itself.
What Are the Most Common Upper Back Injury Symptoms?
If you injure your upper back while doing every day or weekend warrior activities, you may encounter the following symptoms:
Sensitivity to touch
These are common musculoskeletal strain symptoms, but they may also arise as a result of spinal damage. If your upper back discomfort is caused by the bones, nerves, or discs in your thoracic spine, you may also have the following symptoms:
Aches and pains in the lower back
Aching in the legs
Incontinence (leakage from the bowels and/or bladder)
Leg numbness or sluggishness
There’s no need to hurry to the doctor for an assessment if you have modest upper back pain that you can relate to activity. When you experience upper back discomfort and other symptoms, it’s a good idea to contact your doctor to figure out what to do next.
What Causes Back Pain in the Upper Back?
Soft tissue injuries, such as sprains or strains or muscular tension produced by poor posture or prolonged staring downward, are the most common causes of upper back discomfort.
The following are some of the most common habits and activities that might induce upper back pain:
Neck injuries, such as whiplash
Movements that are repeated
Sports involving physical contact
Carrying an excessively heavy weight
Carrying an overburdened backpack
When it comes to the elderly, the list of frequent reasons becomes longer. “We must consider osteoporosis and compression fractures in the elderly, as well as the unusual occurrence of a neoplasm, such as multiple myeloma and lymphoma,” explains Dr. Knight.
However, you don’t have to be a senior citizen to have an issue with your thoracic spine. If your doctor suspects this, you may be tested for the following:
Arthritis in many kinds
Ankylosing spondylitis, for example, is an inflammatory disorder.
A vertebrae fracture
Scoliosis (spinal stenosis)
Scoliosis (cancer of the spine)
Don’t allow that big list of probable, dangerous problems to frighten you too much. “It’s most typically a strain in younger patients – and by young, I mean folks up to their mid-60s,” Dr. Knight explains.
What Are Some Risk Factors for Upper Back Pain?
Let’s say you haven’t visited a doctor about your upper back discomfort yet, but you’re very certain it isn’t an acute injury. You haven’t started a new sport, after all. You may not have enough time to exercise, much alone overdo it.
This, believe it or not, increases your chances of suffering a back injury. The muscles in your belly and back—your core—help maintain your spine while you’re physically engaged.
Sedentary people are more likely to have weak muscles, which may lead to upper back discomfort.
One of the numerous variables that might raise your risk of upper back discomfort is a lack of activity. Other options include:
A lot of weight. Excess weight may put a strain on your back since your spine supports the weight of your body. Belly fat, in particular, is a problem: carrying a lot of weight in your middle puts pressure on your back’s soft tissues. Weight reduction, on the other hand, has been shown to relieve pain; however, evidence shows that it may be even more helpful when combined with other pain management measures.
Psychological problems. Experts aren’t sure why, but sadness and anxiety are linked to an increased risk of back discomfort. According to certain studies, persons who are depressed experience more back discomfort than those who are not depressed.
Smoking. This unhealthy practice decreases blood flow to the spine, denying your back the nutrition it needs to keep healthy. As a consequence, your spine’s discs may deteriorate.
Quitting smoking may help some individuals regain some of their lost weight. Even if the discs do not recover, stopping smoking lessens back pain-causing inflammation.
How Do You Get a Diagnosis for Upper Back Pain?
You’ll start with a talk when you see a doctor for upper or mid-back discomfort. Expect the doctor to inquire about any incidents that may have contributed directly to your condition: Any adjustments or additions to your workout program, such as a fall or a vehicle accident.
On a scale of 0 to 10, you may be asked to rate your pain. You should also be prepared to
discuss how your pain affects your everyday activities, whether it does or does not. Are you able to prepare supper, dress, and shower?
Then there’s the physical exam, which is the portion of your appointment when you’ll be poked and prodded. The doctor is interested in how your upper back discomfort impacts your mobility. In the exam room, you may expect to sit, stand, reach, and bend. After that, you’ll almost certainly get an X-ray.
If your symptoms continue or have “red flags” like growing weakening or bowel or bladder control issues, Dr. Knight recommends further sophisticated testing. He goes on to say that MRI (magnetic resonance imaging) is the most probable option.
Here’s a look at some advanced testing options for upper back discomfort.
Magnetic resonance imaging (MRI) or computed tomography (CT) scans. These scans, unlike X-rays, may provide clinicians with a picture of both bone and soft-tissue injuries. Herniated discs, as well as abnormalities with muscles, nerves, ligaments, and other structures, might be discovered.
Blood tests are performed. Blood testing may reveal infection or any anomalies that might indicate disorders like rheumatoid arthritis or cancer.
A bone density test is performed. The DXA (or DEXA) test determines if you have or are at risk for osteoporosis by measuring your bone mineral density.
Nerve research. Nerves deliver electrical messages to muscles, which they react to. This activity is measured using electromyography (EMG), a type of nerve study. It can tell you if you have a compressed nerve caused by a herniated disc or spinal stenosis (narrowing your spinal canal).
What Are the Most Common Treatments for Upper Back Pain?The variety of therapies available for upper back pain and neck and mid-back pain suggests that there is no one-size-fits-all solution. These are some instances of several ways that may be beneficial to you.
Upper back discomfort is usually not a reason for concern, although it may be unpleasant, severe, and annoying. Furthermore, if pain arises abruptly and is severe—for example, as a result of an accident (e.g., a fall)—and, most importantly, if pain and symptoms (e.g., weakness) intensify over time, you should seek medical help.
Simple home cures are available. The following home remedies may help reduce upper back discomfort in general. Ignore the hoopla surrounding unique items advertised on television or via social media. Stick to what research indicates is best, at least for most persons suffering from modest musculoskeletal pain:
Stretches that are gentle
Ibuprofen (Advil), naproxen (Aleve), or acetaminophen (Tylenol) are examples of over-the- counter medications (Tylenol)
Apply ice to the affected area to relieve discomfort and swelling.
Heat may help with mobility and stiffness.
Exercises that improve posture. If you have an appropriate posture, your spinal structures should be properly aligned, reducing back discomfort. To enhance your standing or sitting posture, start with these tips.
Imagery. Imagine a cable running from the ceiling to the floor through your body. Imagine someone pushing that chord upward, elevating your chest and ribs just a little.
Tuck your chin in. Place your feet flat on the floor and sit on a chair. Your shoulders should be down and relaxed. Pull your chin closer to your neck. Count to five, then take a deep breath and relax. Rep 10 times more.
Squeeze the shoulder blades. Keep your shoulders down, about at chin level, and your hands on your thighs. Squeeze your shoulder blades together slowly. Count to five, then take a deep breath and relax. Rep three or four times more if necessary.
Stretch your upper back. Raise your right arm straight in front of you to shoulder level. Bend your arm at the elbow and take your left hand to that elbow. Pull it over your chest and hold it there for 20 seconds. On each side, repeat three times.
Medications on prescription. A prescription anti-inflammatory or muscle relaxant can be enough to relieve upper and mid-back discomfort in many situations. If your doctor feels depression is causing your pain, you may be prescribed an antidepressant to take for a longer time (months, not weeks). Opioid pain medications may be given for severe pain not relieved by other pain relievers, but they should not be used for more than 7 to 10 days. Finally, anticonvulsant medication may be beneficial; it is most effective for pain caused by nerve injury.
Injections. A trigger point injection is a potent painkiller delivered directly to the trigger point. It may fix your issue or just give you enough pain-free time to seek alternative treatments (such as exercise and stretching; see the hands-on healing bullet below) to alleviate the discomfort of the upper back.
You are healing with your hands. Physical therapy, acupuncture, and chiropractic treatment may all help with upper back pain alleviation. Consult your doctor to see whether doing more than one of these procedures simultaneously is safe.
Most occurrences of upper back discomfort go away on their own within 1 to 2 weeks. Return to your usual activities gradually, as soon as you are pain-free. However, don’t hurry things; you might jeopardize your recovery and risk re-injury.
Surgery. Spine surgery might be frightening, but it is sometimes the only option to obtain relief. Isolated upper back discomfort seldom necessitates surgery. This is usually caused by a problem with the spine, such as a herniated disc, vertebral fracture, or deformity.
What Kinds of Back Surgery May You Require?
Upper back surgery is uncommon, but if it is required, you have alternatives. These are a few of the most popular thoracic spine operations.
Kyphoplasty or vertebroplasty: Your doctor will inject glue-like bone cement to heal compression fractures caused by osteoporosis.
Laminectomy and decompression of the spine. Your surgeon may remove bone walls of the vertebrae to relieve pressure on the nerves if you have spinal stenosis (narrowing of the spinal canal).
Microdiscectomy. When a disc bulges and pushes on a nerve, microdiscectomy – minimally invasive removal of a disc (or section of a disc)– is the gold standard operation.
What Can You Expect From Recovery From Upper Back Pain Treatment?
Your treatment’s effectiveness, at least in terms of pain alleviation, may be determined by the source of your upper and mid-back discomfort.
The bad news is that some folks will always be in agony.
According to University of Washington pain management specialist David R. Patterson, Ph.D., if you have a disease that causes chronic pain, such as fibromyalgia or spinal stenosis, it’s critical to limit your expectations for relief.
“The fact is that the majority of chronic pain is incurable. Dr. Patterson responds, “You can only manage it.” That might imply a treatment method that includes both the body (exercise and medication) and the psyche (talk therapy and relaxation techniques).
Here’s some excellent news. Simply exercising aching muscles more might help relieve musculoskeletal discomfort. Patterson advises against treating back discomfort on your own, particularly if you don’t know what’s causing it. Wait for a doctor’s appointment and, preferably, a prescription for physical therapy, which may help your body recover in ways that make you less likely to be hurt again.
The greatest news of all is that most back pain improves on its own, even if you don’t do anything except waiting.