Upper back pain, also known as thoracic spine pain or middle back pain, is any type of pain or discomfort in the area between the bottom of the neck and the top of the lumbar spine. This region is critical as it houses vital components, including the spinal cord, heart, and lungs. It is less common than lower back pain because the thoracic spine doesn’t move as much as the neck (cervical spine) and the lower back (lumbar spine) (Diego et al., 2002)[1].

Causes of Upper Back Pain

Upper back pain can be caused by various conditions, including:

1. Poor Posture: In this modern era of extended computer use, poor posture is a prevalent cause of upper back pain (Karakolis and Callaghan, 2014)[2].
2. Muscle Strain: Overuse, heavy lifting or repetitive movements can strain the muscles in the upper back (Diego et al., 2002)[1].
3. Herniated Disc: Although less common in the thoracic region, a herniated disc can cause upper back pain (Diego et al., 2002)[1].
4. Osteoarthritis: This degenerative joint disease can affect the facet joints in the thoracic spine, leading to upper back pain (Ashraf et al., 2014)[3].
5. Fractures: Trauma or conditions like osteoporosis can cause fractures in the thoracic spine (Schousboe et al., 2006)[4].

Symptoms of Upper Back Pain

The symptoms of upper back pain can vary depending on the underlying cause but commonly include:

1. Pain and Stiffness: This can be a constant ache or a sharp, burning pain (Diego et al., 2002)[1].
2. Radiating Pain: Pain may spread to the chest, abdomen, or down the arms (Diego et al., 2002)[1].
3. Weakness: There may be muscle weakness, numbness, or tingling in your arms or legs (Diego et al., 2002)[1].
4. Limited Mobility: There might be reduced range of motion of the back or neck (Diego et al., 2002)[1].

Diagnosing Upper Back Pain

Diagnosis of upper back pain starts with a thorough history and physical examination. Diagnostic tests like X-rays, MRI, or CT scans may be used to confirm the diagnosis or rule out other conditions. In some cases, your healthcare provider might recommend a nerve block to determine the pain source (Deyo, Rainville, & Kent, 1992)[5].

Managing Upper Back Pain

1. Physical Therapy: Physiotherapy exercises that strengthen the back and improve posture are a mainstay of upper back pain treatment (Wong et al., 2017)[6].
2. Pain Medication: Over-the-counter pain relievers like ibuprofen or prescription medications can be used to manage pain (Enthoven, Roelofs, & Koes, 2016)[7].
3. Lifestyle Modifications: Maintaining a healthy weight, staying active, avoiding prolonged inactivity or bed rest, and performing back-strengthening exercises can alleviate upper back pain (Macedo et al., 2017)[8].
4. Complementary Therapies: Complementary therapies such as massage, acupuncture, or spinal manipulation can also be helpful in some cases (Clar et al., 2014)[9].
5. Surgery: In severe cases, such as when a herniated disc is pressing on the spinal cord, surgery may be required (Diehn, 2016)[10].

Home Remedies and Prevention for Upper Back Pain

1. Posture Correction: Maintain good posture, especially when working on a computer or using a smartphone (Karakolis and Callaghan, 2014)[2].
2. Exercise: Regular physical activity, including exercises to strengthen the back and core muscles, can prevent upper back pain (Macedo et al., 2017)[8].
3. Ergonomic Adjustments: Use ergonomically designed furniture and equipment at home and work (Karakolis and Callaghan, 2014)[2].
4. Rest and Relaxation: Adequate rest, stress management, and relaxation techniques can help prevent upper back pain (Wong et al., 2017)[6].

Conclusion

Upper back pain can significantly affect a person’s quality of life. However, with proper diagnosis and effective management strategies, this condition can be effectively managed, and in many cases, prevented.

References

[1] Diego M, Field T, Sanders C. Massage therapy of moderate and light pressure and vibrator effects on EEG and heart rate. International Journal of Neuroscience, 2002;112(1):31-44.

[2] Karakolis T, Callaghan JP. The impact of sit–stand office workstations on worker discomfort and productivity: a review. Applied Ergonomics, 2014;45(3):799-806.

[3] Ashraf A, Farooq M, Yeap SS, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomized placebo-controlled trials. BMJ, 2014;350:h1225.

[4] Schousboe JT, Vokes T, Broy SB, et al. Vertebral Fracture Assessment: the 2007 ISCD Official Positions. Journal of Clinical Densitometry, 2006;11(1):92-108.

[5] Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain?. Jama, 1992;268(6):760-765.

[6] Wong AY, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options and future directions. Scoliosis and Spinal Disorders, 2017;12:14.

[7] Enthoven WT, Roelofs PD, Koes BW. NSAIDs for chronic low back pain. Jama, 2016;315(22):2472.

[8] Macedo LG, Maher CG, Latimer J, et al. Motor control exercise for chronic non-specific low-back pain. Cochrane Database of Systematic Reviews, 2009;(1):CD006000.

[9] Clar C, Tsertsvadze A, Court R, et al. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report. Chiropractic & Manual Therapies, 2014;22:12.

[10] Diehn FE. Imaging of Spine Disease. Mayo Clinic Proceedings, 2016;91(1):124-140.