Upper Back Pain

Upper Back Pain

When we think of back pain, generally, we tend to to think of the lumbar spine, or lower back, and cervical spine (the neck). Both of those common areas of the spine are designed to provide you with mobility but, the thoracic spine, or upper back, is designed to be very strong and stable and allow us to stand upright while protecting the vital internal organs of the chest. Even though pain in your upper back may be uncommon, we, at Nebraska Spine Hospital, still think it’s important to understand as it can cause significant discomfort and pain when it does occur.

What Produces Upper Back Pain?

Often poor posture accounts for most cases of upper back pain, especially for those who sit at a computer all day long. Ideal posture is neutral; it allows forces of gravity to travel through the spine in its optimal condition. The problem with maintaining posture is that bad posture is habitual. However, there can be specific instances that might cause pain in the thoracic spine; muscular irritation and joint dysfunction.

Muscular Irritation Causing Upper Back Pain

The upper back is comprised of muscles that attach the scapula (shoulder blade) and the back of the thoracic rib cage. These upper back muscles are prone to developing muscular irritation, or myofascial pain.

Often this type of pain is due to de-conditioning (where the muscles aren’t ready to take on the stress that is applied to them) or overuse injuries, typically caused from repetitive motions. You can also experience muscular irritation due to motor vehicle accidents, sports injuries, muscle strains, or other injuries.

Upper back pain is most responsive to manual treatments such as active/passive physical therapy, exercise, chiropractic manipulation, massage therapy and acupuncture. Since your upper back is related to large muscles in the shoulder area, you can expect a great deal of strengthening and stretching exercises in your rehabilitation program.

Joint Dysfunction Causing Upper Back Pain

The ribs connect with the vertebrae in the thoracic spine by two joints that connect with each side of the spine. Dysfunction in the motion of these joints can cause upper back pain.

As with muscular irritation, upper back pain due to joint dysfunction is most responsive to manual treatments. The goal here is to mobilize the joint in order to reduce the discomfort. For lasting relief, a home exercise regimen will be needed in order to strengthen and stretch the spine and shoulders. Aerobic exercises can be useful in maintaining sustained upper back pain relief.

Pain medications can be helpful in the treatment of back pain caused by both muscular irritation and joint dysfunction. Both of these types of ailments usually cause inflammation so using an anti-inflammatory is the best kind of medication you can take; look for ibuprofen or a COX-2 inhibitor.

Uncommon causes of Upper Back Pain

We’ve established that upper back pain, or pain in the thoracic spine, is fairly uncommon due to the fact that there is little motion and a great deal of stability through this region. Because of this, the thoracic spine is not likely to develop disc herniations, spinal stenosis, degenerative disc disease, or instability (spondylolisthesis). Most of these conditions occur in the lumbar spine, where there is more mobility.

If you are experiencing any upper back pain and would like to talk to speak to someone about your symptoms, you can visit Nebraska Spine + Pain Center’s website or call 402.415.2332 to make an appointment with any of our board certified and fellowship trained Orthopaedic Spine Surgeons.