Of the different types of back pain, upper back pain is not likely to stand in the spotlight often. People experiencing back pain usually focus on their lower back. The truth is that many may be suffering from upper back pain without knowing what it is. There are ways to diagnose upper back pain and to find upper back pain relief, keeping this area of the back strong, healthy, and pain-free.
Upper back pain relief
Upper back pain relief starts by first identifying this often-ignored area of the back. The upper back is also known as the thoracic spine. The thoracic spine has 12 vertebrae. These run from the base of the neck to about five inches below the bottom of the shoulder blades. This area of the back is the least flexible area, holding the ribs that protect vital organs and connecting the cervical spine (neck) and the lumbar region (lower back).
Because this area is less flexible than the lumbar and cervical regions of the spine, it can suffer muscle strain and injury easily when used incorrectly. Other causes of upper back pain include the following.
In the U.S., adults spend an average of eight hours a day sitting down in front of a screen (computer, phone, or television). In this position, the tailbone is tucked under, rounding the lumbar and lower vertebrae of the thoracic spine. The shoulders droop forward, rounding the upper part of the thoracic spine. The cervical spine is compressed and held forward of the shoulders. This places tremendous pressure on the neck. Upper back pain is just one of the effects of too much screen time.
This poor posture continues during the average 30-minute commute to and from work daily. With hands on the steering wheel and shoulders hunched forward, the muscles of the upper back are rounded and stretched all day. After hours of sitting in a car and staring at a screen, finding upper back pain relief can be difficult.
Disc bulging or herniation
While many people suffer from a herniated or bulging disc in the lower back, this type of injury can also occur in the thoracic spine. The gel-filled cushion between vertebrae is pushed out from between each vertebrae. This causes pain and inflammation. Over time, this can also cause nerve pain as the vertebrae push on spinal nerves. The disc may also herniate (rupture), leaking the protective fluid. Once this occurs, the pain can be debilitating and immobilizing.
Small fractures to the thoracic spine
While rare, fractures can occur in the upper back. These can be a result of osteoporosis or other type of bone deterioration (e.g., deterioration caused by spinal tumors).
These fractures may not always result in pain, but they can have an additional consequence: the development of a “dowager’s hump.” These are seen when a fracture occurs in the upper back, causing the spine to begin to curve outward. Also known as kyphosis, if left untreated, the spine may become permanently misaligned in this curved shape.
Kyphosis occurs most often in older women experiencing bone loss, hence the term “dowager’s hump.”
How to find upper back pain relief
As with many pain conditions affecting the back, finding upper back pain relief is most successful with prevention before pain starts.
There are many lifestyle changes that can be made to prevent upper back pain, including:
- Exercise: Getting daily, vigorous exercise that includes bodyweight exercises for the upper back – push-ups, planks, etc. – is one of the best preventions for upper back pain. Strong muscles support the bones and keep length and strength along the spine. Exercise also helps to maintain balance and flexibility. Both of these are important in preventing injury-causing falls.
- Diet: As we age, protein requirements increase. It takes twice as much protein to maintain muscle mass. When the muscles of the abdomen and back can no longer support the spine, injury can occur. Proper diet can help keep muscles strong.
- Stop smoking: Among other dangerous health effects, smoking increases the rate of bone loss and dampens the immune system. While quitting smoking cannot replace or repair lost bone, it has immediate positive effects. These include increased absorption rates of dietary calcium to prevent future bone loss.
When upper back pain occurs, finding upper back pain relief usually begins with non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs may help with pain to make exercise or physical therapy possible. These NSAIDs may be over-the-counter ibuprofen, or your doctor may prescribe a short course of prescription anti-inflammatories.
Interventional options for upper back pain relief
If NSAIDs and changes in lifestyle do not provide relief from back pain, doctors may look to epidural corticosteroid injections. These injections are administered directly into the epidural space. They offer relief from pain with a numbing agent such as lidocaine, followed by a steroid that can help to reduce inflammation. The downside of these injections is that long-term use of steroids has been linked to damage to the connective tissue and thinning of bones in the injection area. Although this is a minimally-invasive procedure, there is the potential for infection at the injection site as well as nerve damage if the needle is not correctly placed.
Doctors may also use facet joint injections or medial branch blocks for more targeted pain relief in the facet joint or to numb nerve signals completely. Medial branch blocks do carry with them the risk of cardiac side effects. Both injections can cause infection or other unpleasant side effects such as numbness.
If a herniated or bulging disc is the cause of pain, upper back pain relief can be experienced for up to two years with a partial discectomy (also known as a percutaneous discectomy). This procedure is also considered minimally invasive also. It removes some or all of the intervertebral disc material that is causing the pain and inflammation.
Treating spinal fractures
Two final treatment options for upper back pain relief are a vertebroplasty that uses cement to repair a spinal fracture and a kyphoplasty, which is a variation of a vertebroplasty that inserts a small balloon to help more accurately place the cement. Leaking cement over time can cause nerve damage and more pain, but for the most part this procedure is also considered safe and effective for upper back pain relief.
While not as common as lumbar and neck pain, upper back pain can nevertheless be difficult to live with. If you have experienced upper back pain in the past, what helped you find relief?