What is upper back pain?

What is upper back pain?

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Upper back pain refers to discomfort, aching, or stiffness that is localized in the thoracic region of the spine, which includes the area beneath the neck (cervical spine) and the bottom of the ribcage (lumbar spine). The upper back is also known as the thoracic spine and consists of twelve vertebrae (T1 to T12) that are connected to a pair of ribs, along with the sternum (breast bone) at the middle portion of the chest to form the rib cage.

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Upper back pain can vary in intensity, ranging from mild to severe, and may present as aching, stabbing, or burning sensations. It can be acute, lasting for a short period due to a specific cause or injury, or it can be chronic, persisting for more than three months. 

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Causes of upper back pain

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Common causes of upper back pain include:

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1. Muscle strain: Overuse from repetitive motions or sudden strenuous activities that strain the muscles in the upper back, such as lifting heavy objects or maintaining poor posture for extended periods.
2. Poor posture: Slouching or hunching over while sitting, standing, or using electronic devices in long periods can put stress on the upper back muscles and cause pain.
3. Trauma or injury: Accidents, falls, or sports-related impacts can lead to upper back pain due to muscle or ligament strains, fractures, or dislocations.
4. Herniated or bulging discs: Discs between the vertebrae can herniate or bulge, potentially putting pressure on nearby nerves and causing upper back pain.
5. Osteoarthritis: Degenerative changes in the joints and discs of the upper back can lead to arthritis-related pain.
6. Poor sleeping position: Sleeping in an awkward position or using an unsupportive mattress can contribute to upper back pain.
7. Myofascial pain syndrome: Trigger points or knots in the muscles of the upper back can cause referred pain.
8. Postural abnormalities: Conditions like scoliosis or kyphosis, which affect the curvature of the spine, can lead to upper back pain.
9. Medical conditions: Certain medical conditions like fibromyalgia or osteoporosis can cause upper back pain.

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Treatment for upper back pain will depend on the underlying cause and the severity of the symptoms. In many cases, conservative approaches like rest, over-the-counter pain medications, ice or heat therapy, and gentle stretching exercises can help alleviate the pain. Physical therapy can also be beneficial for improving posture, strengthening muscles, and addressing muscular imbalances. For more severe or persistent cases, medical intervention and further diagnostic testing may be necessary to determine the cause of the pain and implement appropriate treatment options.

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What does upper back pain feel like?

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Upper back pain can manifest in various ways, and the sensation may differ from person to person depending on the underlying cause and severity of the pain. Common symptoms and  descriptions of upper back pain include:

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1. Aching or stiffness: Many people with upper back pain describe a dull, persistent ache or stiffness in the upper back region. This type of pain may be mild to moderate in intensity and can be aggravated by certain movements or postures.
2. Sharp or stabbing pain: Some individuals may experience sharp, stabbing pain in specific areas of the upper back. This type of pain is often more intense and may occur suddenly, especially with certain movements or activities.
3. Burning or tingling sensations: Upper back pain may sometimes be accompanied by a burning or tingling sensation, which can indicate nerve involvement or irritation.
4. Tenderness to touch: The affected area of the upper back may feel tender to touch, and pressing on the muscles or spine can exacerbate the pain.
5. Radiating pain: Upper back pain may radiate to other areas, such as the shoulders, neck, or arms. The patient may feel numbness, and tingling sensation. This can occur if the pain is due to nerve compression or irritation.
6. Limited range of motion: Individuals with upper back pain may experience difficulty moving their upper back, neck, or shoulders due to pain and stiffness.
7. Postural discomfort: The pain may worsen with certain postures, such as slouching or sitting for extended periods.

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It's important to note that upper back pain can be caused by various factors, including muscle strain, poor posture, herniated discs, osteoarthritis, and other underlying medical conditions. The exact symptoms experienced can vary based on the cause of the pain and the individual's overall health.

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If you are experiencing upper back pain that is severe, persistent, or accompanied by other concerning symptoms, it is essential to seek evaluation from a healthcare professional for an accurate diagnosis and appropriate management plan. Proper assessment and diagnosis are crucial to determine the cause of the pain and develop an effective treatment strategy.

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How can physical therapy help?

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Physical therapy can be highly effective in managing and relieving upper back pain. A skilled physical therapist can design a personalized treatment plan to address the specific cause of the pain and the individual's unique needs. Here are some ways physical therapy can help with upper back pain:

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1. Pain relief: Physical therapists use various techniques and modalities, such as heat or cold therapy, electrical stimulation, ultrasound and manual therapy, to reduce pain and inflammation in the affected area.
2. Posture/Kinesthetic Training: Poor posture is a common cause of upper back pain. Posture/kinesthetic training aims to develop patient awareness of safe spinal positions and spinal movement as well as the effects of different positions (e.g. lying, sitting, standing) have on the spine. Awareness of what posture makes the symptoms better or worse and identifying the neutral spine position or position of bias are important in helping patients manage their symptoms. Active control of spinal position and correct posture are reinforced in a variety of ways until it becomes habitual. 
3. Stretching exercises: Decreased flexibility in joints, muscles, and fascia may restrict the patient’s ability to assume normal spinal alignment. Manual techniques and safe self-stretching techniques as well as joint mobilization are used to increase muscle, joint and connective tissue mobility. 
4. Stabilization and Strengthening exercises: Stabilization exercises are prescribed to emphasize movement and resistance to the extremities while maintaining control of the spinal position. It includes activation of the deep segmental stabilizing muscles and exercises to develop spinal control in the global stabilizing muscles which are fundamental for developing spinal stability. Increasing the time and number of repetitions builds muscle endurance at each level of performance. When the patient learns effective spinal control with the stabilizing muscles in a variety of stabilization exercise routines, dynamic trunk and neck strengthening exercises are introduced to improve spinal muscle strength and performance. 
5. Manual therapy: Physical therapists may use hands-on techniques, such as deep tissue  massage and myofascial release, to release tension in the upper back muscles and promote relaxation.
6. Aerobic Conditioning: Aerobic conditioning exercises are initiated as soon as the patient tolerates repetitive activities without exacerbating symptoms. Emphasis is placed on using safe spinal postures while exercising. Aerobic activity increases the patient’s feeling of well-being and improves cardiovascular and pulmonary fitness.
7. Education: A physical therapist can educate the individual about upper back pain, its causes and other symptoms as well as the role and importance of rehabilitation programs in managing the condition. They also teach patients about proper body mechanics, safe ways to exercise , and lifestyle modifications to minimize stress and prevent future episodes of upper back pain.
8. Ergonomic assessment: Physical therapists can assess the individual's home and work environment as well as daily activities to identify ergonomic factors that may be contributing to upper back pain. They can then provide recommendations for adjustments or modifications to correct the stresses and prevent future recurrence of symptoms. 
9. Breathing exercises: Some individuals with upper back pain may benefit from learning proper breathing techniques to reduce tension and promote relaxation in the upper back and surrounding muscles.
10. Postural Stress Management and Relaxation Techniques: It is common that a patient's symptoms are exacerbated with sustained postural stresses such as sitting at a computer, talking on the phone (head tilted) or repetitive forward bending. The patient is then advised by the physical therapists about methods to correct the sustained or repetitive postural stresses. In addition, frequent changes of position and movement through the pain-free range of motions are encouraged. They will also teach the patient how to consciously relax tension in muscles to relieve stress.
11. Home exercise program: A physical therapist can design a home exercise program tailored to the individual's needs, and teach how to safely and effectively incorporate it into their daily routine to reinforce the intervention and promote optimal recovery. 
12. Functional training: Once the patient has learned spinal control and stabilization and has developed adequate flexibility and strength for specific tasks, components of the task are incorporated into the exercise program and then into the patient’s daily lifestyle. Safe body mechanics are included in all aspects of care. 
13. Prevention Strategies: Education occurs on a continual basis. Physical therapists provide strategies for the patient to prevent recurrence of upper back pain which includes:

• When experiencing pain or the recurrence of symptoms, check posture. Avoid any one posture for prolonged periods.
• If sustained postures are necessary, take frequent breaks and perform appropriate range of motion exercises at least every half hour. Finish all exercises by assuming a well-balanced posture.
• Avoid hyperextending the neck or being in a forward-head posture or forward-bent position for prolonged periods.
• If in a tension-producing situation, perform conscious relaxation exercises.
• Always follow good safety habits.

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By addressing the underlying causes of upper back pain and providing targeted interventions, physical therapy can not only alleviate immediate discomfort but also prevent future recurrences. It is essential to work with a qualified physical therapist who can tailor the treatment plan to the individual's specific needs and monitor progress effectively. If you are experiencing upper back pain, consider seeking evaluation and guidance from a healthcare professional to determine if physical therapy is a suitable option for your condition.

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Trust PeteHealth for treating upper back pain 

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