Upper Back Pain: What can be the cause and when should I see a doctor?

Dr Philip Altieri

Why does my upper back hurt at the end of the day? Why does my upper back hurt worse in the morning upon awakening? Why can’t I fully turn my head to the side? These are very common questions we here every day from new patients that enter our clinic looking for answers and treatment options! Although there is not an all-in-one answer that encompasses all potential conditions related to pain felt in the upper back, we usually find a few common causes that are independent of an injury, accident, slip, or fall.

The upper back is a very important and unique area of the body and musculoskeletal system. This spinal area is referred to as the proximal thoracic spine and is a junction point of the cervical spine (neck), both shoulders, mid thoracic spine (middle back), clavicles (collar bones), ribs, and scapulas (shoulder blades). It is also a congregation junction point where many nerves from the neck and upper back come together forming a plexus that branches out down the arms, back, chest, and shoulders.

So, what should occur to find out what’s causing your upper back pain and what can you do to help yourself at home?

While symptoms or pain should never be ignored, if your painful condition persists or worsens, it’s time to seek out a qualified healthcare provider. But, most of us know if we’ve simply tweaked a muscle, slept on our neck/upper back wrong, or just over used a muscle as the pain should resolve quickly and without further occurrences. If some heat, ice, or stretching doesn’t help or get rid of the pain, than there may be an underlying issue that should not be ignored by taking painkillers to mask the symptoms either.

It’s probably time to seek an experts opinion and knowledge like a chiropractor. Upper back pain can be caused by many different things and not all types of doctors are experts in that area of the body. Seeking out an experienced chiropractor with a good reputation may be the best option as they are trained to examine and diagnose most related conditions that potentially could be producing the pain and discomfort.

First things first, a complete history should be taken by the doctor, both past and present. Secondly, a complete and thorough examination should occur of the chief complaint area as well as an overall full body evaluation as the pain may not be primarily centralized or referred from another region. Next, depending on the exam findings, the doctor may or may not want some type of imaging of the area such as x-rays, MRI, CT scan, or ultrasound. Then, a report of findings should take place that will include a diagnosis, treatment options, and prognosis.

Here are some common causes of upper back pain:

  • Poor Posture– Commonly referred to as muscle deconditioning, is more common in women. Typically occurs over time from bad habits, slouching, slumping forward, working long periods on computer, sitting at desk without frequent breaks, or even poor sleeping positions and using 2 pillows.
  • Injury– This can be a whiplash from a car accident, sports related, work related induced, slip or fall, and even lifting or bending incorrectly.
  • Muscle overuse– Typically related to repeated actions or motions over time causing tightness, stiffness, irritation, or strain/sprain. Can also occur by performing a duty or task all at once that you’re not normally accustomed to performing.
  • Osteoarthritis– Commonly referred to as as arthritis, is a process that happens over time whereby the bones and joints start to breakdown and degenerate. This can put pressure on the spinal nerves and cause pain, muscle weakness, numbness or tingling.
  • Pinched nerve– When a nerve becomes irritated or compressed it can cause pain, numbness, tingling, muscle weakness or physiological dysfunction.
  • Herniated disc– Discs are semi-soft cartilaginous spacers between adjacent vertebrae in the spine. Herniations occur when the inner thick, viscous, gelatinous fluid pokes through the outer fibrous layer of the disc putting pressure on the spine, nerves, and associated structures.
  • Myofascial pain– This is a network of interwoven connective layered muscles that help in stabilization, support, and movement of the spine and musculoskeletal system. When stressed, injured, or compromised, it produces a pain syndrome.
  • Scoliosis– This is a lateral deformity and curvature of the spine that can affect the normal functioning, movement, and supportive characteristics.

Treatment type and length for each condition listed above will vary and have various degrees of success depending on the diagnosis, severity of condition, how long you’ve had the condition, patients overall general health and age, and the patients commitment to follow a care plan.

Some less common and rare causes of upper back pain would include a spinal epidural abscess or infection, lung cancer, or congenital spinal deformity to name but a few. Having said that, a knowledgeable and diligent clinician will keep all possible differential diagnosis’ on the table, especially if the patients pain and condition are not responding to a prescribed treatment regimen.

Visiting a chiropractor’s office would be a great place to start! Why, because they are leaders in the healthcare industry in the diagnosis and successful treatment of upper back pain and musculoskeletal disorders! And, if something more serious is found than they can assist in finding the correct physician or facility to refer you to for appropriate treatment. Chiropractor’s offer many noninvasive, nonsurgical treatment options to successfully treat and manage your upper back pain in the least amount of time. Plus, a doctor of chiropractic can suggest, teach, and manage many home treatment regimens for upper back pain that you can perform on your own!

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