Upper Back Pain Causes
Upper back pain, defined for this article as being pain in the back from the low cervical spine at C7 down to the mid thoracic spine around T6, is not as common as lower back pain but can be very troublesome and disabling when it does occur.
Degenerative disc changes and disc prolapses are very uncommon in this area of the spine so most of the pain problems arise from different causes, with similar middle back pain causes for that section of the spine.
Back pain symptoms in the upper back include an annoying, persistent aching, sharp pains on certain movements such as rotation, stiffness and a feeling of not being able to get comfortable in a sitting position.
The most common causes of upper back pain are poor posture and repeated overstrains in activities, with rarer examples of sudden injury or trauma. The difficulty with back pain causes in general is less problematical in upper back pain. Present work practices with large amounts of time spent sitting at desks and using computers have contributed to an greatly increased reported incidence of this kind of back pain.
Upper back pain does not commonly exist entirely on its own, it may be referred from the neck or co-exist with neck pain and shoulder pain. The junction between the seventh cervical vertebra (C7) and the first thoracic (T1) is the point where the very mobile neck joins the very stable thorax, leading to tensions which often show themselves as upper back and neck pain. Kidney pain may show itself as mid back pain in the flanks or over the lower ribs, a kind of side and back pain.
“Muscular irritation” is assumed to be one of the most important causes for this type of pain although the evidence for this is not good. However, spending long periods in a poor posture such as at a desk may bring on muscular aching in the neck and upper back. Maintaining the posture of the heavy head is the job of large muscles such as the trapezius and other neck, thoracic and shoulder blade muscles. Painful and tender areas may develop which are known as trigger points and which can cause pain to be referred away from the source areas.
There can be a number of precipitating factors for this kind of muscular pain including whiplash injury from car accidents, overuse injuries, sports injuries and sudden performance of an activity for which we are not fit or prepared.
The facet joints in the thoracic spine are similar to those in other spinal areas and subject to stresses and strains and to postural abnormality. The ribs connect to the body of the individual spinal bones by two small joints and these costovertebral joints can also become “dysfunctional” and cause pain.
Discogenic pain is relatively commonly implicated in low back pain and in the neck and should always be considered when thinking about lower right back pain causes or lower left back pain causes. However it is very uncommon to find a disc related pain problem in the upper or mid back.
Back pain treatment from a physiotherapist involves the assessment of the presenting condition and an examination of the back and related areas. If looking at right side back pain causes a physio may decide to apply mobilising techniques to the joints of the right side of the back and give advice and exercises to both mobilise and stabilise this area. A physio can use many techniques to provide back pain relief although rarely a back pain cure as the causes of back pain are many and difficult to influence. Exercise for back pain is one of the key activities to keep up to help prevent and manage back pain, general exercise being beneficial and specific back exercises having little evidence for usefulness.