Pain in the upper back typically results from muscle overuse, poor posture, or injury. Although treatments will vary depending upon the exact nature of your condition, most cases are easily remedied with physical therapy, rest, and gentle exercise.
The upper back refers to the region between the bottom of the ribcage and the base of the neck. There are 12 bones (T1- T12) that compose this region, which doctors have termed the thoracic spine. The first bone (T1) meets with the base of the neck, while the 12th bone (T12) ends just beneath the ribcage. When it comes to upper back pain, however, symptoms may arise anywhere between these two points.
Most people describe their upper back pain as a burning sensation in a single spot. This discomfort usually signals the location of an injury or strain.
Common Causes of Upper Back Pain
Upper back pain is not as common as lower back or neck pain. However,10% of men and 25% of women nevertheless suffer from this condition.
Upper back pain may arise for a variety of different reasons. Listed below you can find some of the most common culprits:
Muscle Deconditioning & Poor Posture
Some people condition their muscles to be able to withstand ever-increasing amounts of exercise or weight training. However, the reverse can be just as true. Over time, not using your muscles properly (or at all) can decondition them.
For example, do you ever find yourself sitting in an awkward position at your desk while you slog your way through mountains of work? Many people do this every day without even knowing it. Slouching in a chair or hunching over a desk for long periods of time may cause a loss of muscular strength in the thoracic spine. Over time, this weakening may lead to strains (micro-tears) in the muscles that support this area. When a person slouches in a chair (or any other environment for that matter), the pressure of gravity pushes downward on the spine, neck, discs, and ligaments. Without intervention, this constant pressure can lead to pain or health conditions such as degenerative disc disease or arthritis.
Of course, you can condition even the weakest muscles to become stronger. But, this process begins with adopting correct posture while sitting. In addition, it is important to take regular breaks from long periods of inactivity by moving around and introducing stretching into your routine. Exercising will help to improve the strength of the back and using a standing or adjustable desk will force you to stand instead of sit.
It’s important to note that conditioning takes patience, however. If you have chronic back pain, it might be best to see a physical therapist to determine the exercise routine that is best for you.
Traumatic Back Injuries & Thoracic Spine Discomfort
Traumatic injuries to the spine can also lead to upper back pain. Here are a few examples of events that can precipitate an upper back injury:
- Slip and fall accidents
- Automobile accidents
- Workplace or construction accidents
- Improper lifting technique
- Overdoing it during a workout routine
Sometimes, an upper back injury is both obvious and immediate, with pain appearing right after the incident takes place. In other instances, pain may not fully emerge until the next day. These injuries can be rather severe, leading to a cascade of complications. For example, a fractured thoracic vertebra may eventually lead to chronic pain, nerve damage, or paralysis.
While examining you, your doctor should consider back injuries as a potential diagnosis, as doing so will ensure that you receive the correct treatments. Depending on the nature of your ailment, your doctor may refer you to a physical therapist to encourage your injuries to heal properly. In some cases, your doctor may refer you to a specialized surgeon if your condition warrants immediate attention.
Muscle Overuse & Upper Back Pain
Overuse of upper back muscles is a common culprit of thoracic pain as well. Usually, this occurs from repeating the same motions over and over for a long period of time.
For example, athletes who perform repetitive movements, such as baseball pitchers, are more likely to develop this type of problem. The repeated motion of throwing the ball at high speeds applies extreme stress to the shoulder and muscles of the upper back.
Other repetitive activities can lead to similar results. Anyone who has had to perform the same motion for a long time will eventually experience muscle strain and tightness. If these repetitive actions continue, it can easily lead to chronic pain.
For muscle overuse, the best treatment usually begins with resting the area while using alternating application of ice and heat. If possible, find ways to avoid repeating the same motions that precipitated the original problem.
Again, your doctor may recommend that you see a physical therapist to obtain an ideal exercise regimen for your specific case.
Thoracic Herniated Discs
These are much more common in the lumbar region of the spine. However, slipped or herniated discs may occur in the upper back as well.
Intervertebral discs are the soft, cushiony shock absorbers that rest between each vertebra of your spine. Like a jelly donut, an intervertebral disc contains a viscous, gel-like center. A thoracic herniated disc occurs when a portion of this gel pokes through the hard outer shell of the disc and applies pressure to adjacent areas of the spine. Even a small amount of pressure on nerve roots may lead to severe pain in the innervated areas, as well as symptoms, such as weakness in the arms or legs.
Most patients do not require surgery for this condition, as it is generally resolved via more conservative methods. Most of the time, patients will recover from a thoracic herniated disc following plenty of rest and a round of anti-inflammatory meds. That being said, there are going to always be some cases in which surgery is necessary. Speak to your doctor to obtain more information.
Of course, sometimes back pain stems from the bones and joints themselves, not just the muscles. As a person ages, the cartilage that protects the bones may wear down, leading to thoracic osteoarthritis. This condition is very common among the elderly, as the condition itself results from years of wear and tear.
With osteoarthritis, the cartilage between the bones will eventually erode completely, causing the bones to grind together. This may also put pressure on nearby nerves, generating burning or tingling in the extremities.
If you believe you have osteoarthritis, then you should seek medical attention for diagnosis and treatment. Your condition will only get worse with time, so it is important to receive treatment as early as possible. Most of the time, treatment is conservative and focuses on managing pain and keeping the joints in alignment. That being said, if your condition becomes severe enough, surgery may be the only viable route. It all depends on the nature of your condition and how early you receive treatment for your osteoarthritis.
If you have upper back pain or any of the conditions detailed above, please contact The Advanced Spine Center at (973) 538-0900. Our doctors specialize in minimally invasive treatments to resolve a variety of conditions, including thoracic discomfort! To schedule an appointment with one of our board-certified spine specialists, contact us today!