The thoracic spineвalso referred to as the upper back or middle backвis designed for stability to anchor the rib cage and protect vital internal organs within the chest. Although the thoracic spine is relatively stable, it can be the cause of upper back pain. Read Compared to the neck (cervical spine) and lower back (lumbar spine), the upper back is remarkably resistant to injury and pain. When upper back pain does occur, it is typically due to long-term poor posture or an injury that overpowers the thoracic spineвs sturdiness. Watch This article explores various symptoms of upper back pain, potential causes, and modern diagnostic methods and treatments. The thoracic spine starts beneath the neck and is comprised of 12 vertebrae, labeled T1 through T12, which go down the back of the torso (
). Unlike the cervical spine and lumbar spine, the thoracic spine is relatively immobile because each of its vertebrae are connected to a pair of ribs (one on each side), which along with the sternum at the front of the chest combine to form the rib cage. If the upper back becomes painful, it is typically for one of the following two reasons: Muscular irritation. The shoulder girdle attaches by large muscles to the scapula (the shoulder blade) and the back of the rib cage.
These large upper back muscles are prone to developing strains or tightness that can be painful and difficult to alleviate. Muscular irritation in the upper back is typically due to either de-conditioning (lack of strength) or overuse injuries (such as repetitive motions). See Joint dysfunction. Either from a sudden injury or natural degeneration due to aging, joints in the thoracic spine can become dysfunctional and painful. Some examples could include a facet jointвs cartilage or joint capsule tearing If upper back pain becomes bad enough to limit activities, it usually feels like a sharp, burning pain localized to one spot or a general achiness that can flare up and possibly spread to the shoulder, neck, or elsewhere. Few studies have been done to track the frequency of upper back pain. A French study of workers across various professions found about 9% of men and 17% of women reported at least some upper back pain, but other studies have found numbers that range lower and higher. 1,2 Upper back pain can appear suddenly, such as from an injury or for no apparent reason. It can also start gradually, such as from sitting with poor posture at work.
See In some cases, upper back pain can be managed with self-care, including rest, adjusting posture, or applying heat or ice. If the pain persists, other treatments may be needed, such as medication, physical therapy, or manual manipulation. Due to a combination of the thoracic spineвs rigidity and close proximity to the heart, lungs, and other vital organs, surgery is less likely to be performed on the thoracic spine compared to the cervical and lumbar spines. Only in rare cases will an MRI or CT scan find an anatomic problem in the thoracic spine that is amenable to any sort of surgical solution for upper back pain. See Most cases of upper back pain are not due to a serious underlying cause, but rare cases may be caused by a progressing infection or illness, or from spinal instability that has started to affect a nerve root or even the spinal cord. In such cases, it is important to seek medical treatment immediately to reduce the risk of the problem becoming worse. See Symptoms that could indicate a serious underlying cause of upper back pain include radiating pain or pins-and-needles tingling in the chest or abdomen, fever or chills, reduced coordination, problems walking, or severe headache.
In addition, upper back pain that follows a high-impact event, such as an auto accident or fall from a ladder, should be evaluated by a doctor. See What are the symptoms? A dull, burning, or sharp pain. Muscle tightness or stiffness. in your arms or legs. Numbness or tingling in your arms, legs, chest, or belly. Loss of bowel or control. How is upper and middle back pain diagnosed? Your doctor will first ask you about your past health, your symptoms, and your work and physical activities. Then he or she will do a. Your doctor may also order an imaging test, such as an or an, to find out if something such as a broken bone or a is causing your pain. You may need more tests to check for other possible causes for your pain. How is it treated? In most cases, people with mild to moderate back pain can manage their symptoms with:, such as (for example, ) and nonsteroidal anti-inflammatory drugs (for example, and ). Heat or ice. , such as, mobilization, or spinal manipulation. But if your pain gets worse and you\’re having a hard time doing your daily activities, you may need to take a prescription pain medicine. Surgery is seldom used to treat upper and middle back pain. How can you care for yourself at home?
There are several things you can do at home to help reduce your pain. For example: Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly. Use over-the-counter pain medicines, such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, and Motrin). These can reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label. Use a heating pad or ice pack. Heat can reduce pain and stiffness. Ice can help reduce pain and swelling. Exercises that stretch and strengthen the muscles in your back, shoulders, and can help improve your posture, decrease your chance of injury, and reduce pain. Practice good posture. Be sure to stand or sit tall. Don\’t slump or slouch. Learn ways to. You might try deep breathing and relaxation exercises or. This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information. В 1995-2015 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.