Anatomy of the Upper Back
The upper back is the most stable part of your back with its limited range of movement and stiffness. This can be attributed to the attachment to the ribs in that area. It is the region below the cervical spine in the neck area and just above the lower back (lumbar spine). The upper back also called the thoracic spine area consists of 12 vertebrae (bones). There are also more bones in the upper spine than in other parts of your spine.
This is what distinguishes thoracic vertebrae from the others. It is a long and thin bony projection that goes downwards to overlap the inferior vertebrae. These spinous processes also reduce the range of movement in the thoracic spine.
This is the opening formed by the anterior segment of the body and the posterior part of the vertebral arch. In addition, it functions to house the spinal cord and the meninges covering it.
These are the joints where the ribs are attached to the thoracic vertebrae. Usually, a person has 12 pairs of ribs that attach to two places; the costal facet, found on the block part of the vertebra, and the costotransverse facet.
These are located between the adjacent vertebrae. They also act as shock absorbers for the spine as it moves. Each intervertebral disc consists of a substance called Annulus Fibrosis and Nucleus Pulpous.
Muscles, Ligaments, and Tendons
The thoracic spine consists of various soft tissues that provide support for it. The muscles, ligaments, and tendons attached to the spine help the body perform basic movements like lifting, climbing, twisting, and throwing, etc. Additionally, the muscles help to power movements, the ligaments are strong, flexible bands that link bones together and tendons help to connect muscles to bones. Some of the muscles in that area include the Trapezius, the Rhomboids, and the Latissimus Dorsi muscle.
Causes of Upper Back Pain
Upper back pain causes are linked to a variety of reasons. Knowing why you have upper back pain becomes important especially when you want to get treatment for it. Some of these reasons include:
Muscle Deconditioning and Poor Posture
Muscles can improve endurance through exercise and weight training. Muscles can also weaken if they are not used regularly. Bad sitting posture also contributes to this including slouching that can lead to muscle weakness and pain in the upper back.
In the same way underuse of muscles leads to deconditioning, overusing your muscles can hurt your everyday life and lead to upper back pain. Overuse results from repetitive use of a particular set of muscles leading to strain and irritation or even tears in the muscles.
Injuries received as a result of car accidents, slipping and falling, incorrect lifting of objects or weights amongst other reasons can also lead to upper back pain. The injury may occur externally and the pain felt immediately but in other cases, the injury occurs internally with little pain. But over time the pain may get worse and more limiting. When pain exists because of an accident, doctors advise that people should get examined to avoid problems that may surface later in life.
Herniated discs are more common in the lower back but they can affect the upper back as well. Discs are soft rubbery cushions located between each vertebra in the spine. Herniated discs occur when a piece of the disc pokes through and pressure gets placed on the spine, resembling a flat tire. Symptoms of a herniated disc include; pain in the arms and legs or numbness.
The cartilage which protects the bones may wear down as a person ages. Osteoarthritis is a common form of arthritis that may eventually lead to the cartilage between the bones wearing away completely and causing the bones to rub together. This causes spine pain and can also lead to increased pressure on the nerves in the spine causing numbness in the arms and legs.
Other causes of upper back pain include:
- Myofascial Pain
- Pinched Nerve
- Spinal Infection
- Lung Cancer
Risk Factors Associated with Upper Back Pain
Sometimes it is not about injuries, posture, or anything physical, there are risk factors that could increase the chances of you having upper back pain. These include:
Your spine is a major support system for your body since it supports your weight, especially in the midsection. Being obese, especially in the belly area increases your chances of being affected by upper back pain. This is caused because the additional weight puts strain on your spine and all the soft tissues in that area. Losing weight might lessen the pain and experience better back health.
If you’re a smoker, the effects of reduced blood flow to your spine is something to worry about since it can result in spine and disc degeneration. Quitting smoking can help in regeneration in some cases or ameliorate the pain from inflammation. There are lots of different aids nowadays to help a person stop smoking.
Symptoms of Upper Back Pain
Sharp Piercing Pain – This pain compares to stabbing pain. It is an intense spike of pain that could also feel like being gripped by a vice. This kind of pain occurs in one spot instead of all over the back.
General Discomfort – Throbbing pain can occur in the upper back and can resonate in other parts of the body like the neck, shoulder, and lower back.
Stiffness – A sharp or throbbing pain could get worse and lead to reduced mobility of the upper back muscles, ligaments, and even joints. Although reduced mobility in the upper back is not as significant, it can hamper your performance of some arm movements like rotating and lifting.
Radiating Pain – Radiating pain can range from minor and dull to sharp pain. It could also come in bouts or occur continually. It is usually only felt on one side of the body and can radiate from the thoracic spine to the arm, chest, or stomach and even father down your body.
Tingling, Numbness, and Weakness – Like radiating pain, numbness or tingling sensations could also travel along nerves from the thoracic spine to the arm, chest, and stomach. This numbness could lead to muscle weakness and the inability to perform your full range of actions.
The exact cause of upper back pain becomes difficult to diagnose since there are several types. However, our expert physicians can help you pinpoint the reason for your pain.
The diagnostic process narrows down to a 3-step process.
Patient History – Our doctors at Southwest Scoliosis and Spine Institute need a complete patient history. Moreover, this enables them to critically evaluate your situation and where the problem could have stemmed from.
The patient history includes the following:
- When the Pain started
- How your Current Symptoms feel
- Injury History
- Lifestyle and Habits
- Family Health History
After the first step of getting the patient’s medical history, the doctor will conduct a thorough physical exam to help narrow down the cause of your upper back pain.
The process includes:
Observation – The back is thoroughly observed for any abnormal bend in the neck or back.
Palpation – The thoracic spine is pressed against your doctor’s hand. Your doctor slides his hand up and down your back while feeling for any tenderness, rib instability, or abnormality.
Clinical Test – Some movement tests are performed to show which movements aggravate the symptoms and where.
Diagnostic Test – Finally, diagnostic tests are conducted.
To diagnose the cause of upper back pain, usually, one or more of the following tests are conducted:
- X-Ray – A radiograph is used to create an image of the bones of the thoracic region. This shows any abnormality in the spine.
- MRI – MRI (Magnetic Resonance Imaging) shows an even more detailed image of the spinal bones. It is the best method for detecting any spinal nerve or cord compressions, infections, tumors, and damaged ligaments.
Medial Branch Nerve Block – This is the use of fluoroscopy to inject a numbing medication near the medial nerves that exist at the facet joint. If the numbing of the joint results in the disappearance of the pain, the source of the pain can be localized and used as a guide to further treatment.
Treatments for Upper Back Pain
The severity of the pain determines which treatment plans are adopted and which medications are administered to cater to the pain. Chronic pain requires a more severe approach than just mild fleeting pain.
Physical therapy is one of the most effective conservative treatments for upper back pain. It involves the manipulation of the muscles to get better use and relieve the pain.
Some techniques we can use include:
- Chiropractic Manipulation
- Massage Therapy
These techniques involve the gentle stretching of the muscles combined with strength training to help with reducing irritation. This also increases the ability of the muscles to withstand use and regain their respective functions. Physical therapy can help to mobilize your joints and reduce your overall discomfort levels.
At Southwest Scoliosis and Spine Institute, depending on what you need, our doctors may ensure that you’re instructed on an exercise regime to help in stretching your spine, shoulders, and muscles to achieve relief from pain.
Tips for a Healthy Upper Back
To maintain a healthy upper back, there are some tips to guide your daily activities.
Correct Lifting – It is fairly easy to twist the wrong way and damage your spine if you are not lifting things properly. To lift correctly, you need to stand as close to the object as you can and use your legs and knees rather than your upper body.
Good sleep – Your body requires good sleep to stay healthy and repair itself. However, it is best to sleep on your side and not on your stomach as sleeping on your stomach tends to put pressure on the spine.
Stretching – Starting your day with stretching not only feels good but also promotes good spinal health.
Stay Active – If you are not physically fit or if you are a couch potato, you are at a higher risk of having upper back pain. Try to stay active by taking walks, working out when you can, and constantly using your back muscles.
- Maintain a Healthy Weight – Unhealthy weight gain could put a strain on your spine and increase your back pain. Consistent exercise and healthy eating habits can help to maintain a healthy weight and prevent upper back pain.
Finally, if you’re suffering from back pain or you have a loved one who is, please call the Southwest Scoliosis and Spine Institute today.
If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.