Causes of Upper Back Pain Explained
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Back pain sucks.
No matter who you are or what you do... if you wake up with crippling back pain... your day is pretty much ruined.
And while we hear a lot more about lower back issues (its more common and more activities aggravate it), upper back pain deserves our attention too.
In this blog post, we're going to look into why people get upper back pain. We'll focus especially on folks who do blue collar jobs and the specific problems they run into.
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Back Anatomy Key Terms
In order to discuss the cause of upper back pain, I'm going to have to throw around some medical terms that aren't common knowledge:
Spine: "The a well-engineered structure of bones, nerves, muscles, ligaments, and tendons" that run along your back, enabling you to walk upright.
Thoracic Spine: Your thoracic spine is the middle section of your spine. It starts at the base of your neck and ends at the bottom of your ribs. It consists of 12 vertebrae and is used to keep you stable and upright, as also holds up your rib cage.
Cervical Spine: The uppermost part of your spine... connecting the thoracic spine to your head.
Vertebral Bones: The pieces connected together that make up your spine. Humans have 33 vertebrae that include 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal.
Spinal Nerves: groups of "nerve fibers" ("threads of neuron extensions" ) bundled together. They carry sensory information from your body to be interpreted by your brain.
Spinal Discs: flat, circular "pads" made of cartilage and nucleus pulposus that cusion your vertebrae so that they do not grind into each other
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The Relationship Between Spinal Health and Muscle Tension
The spine basically does three things for you:
1) It keeps you balanced upright
2) It supports the rest of body, serving as a "pillar" that the rest of the upper body can build around
3) It carries tons of spinal nerves, giving your brain access to the rest of your body
All the different pieces that make up your spine fit together PERFECTLY. And while they are flexible, they are only supposed to bend and move a specific number of ways.
In one sense, they are kind of like any machine. And just like machines, it only works when it is being operated PROPERLY. So how do you "operate" your spine and vertebrae wrong and get it damaged?
BAD FORM OR POOR POSTURE.
Bad posture messes up how our spine lines up or puts too much pressure on the vertebrae and ligaments. This can lead to pain, stiffness, and reduced mobility in the upper back.
It's like trying to operate heavy machinery with the weight all out of wack... sooner or later something on the machine will break (if it doesn't flip over). And since they are brittle bones and fragile cartilage, our spines could break easily.
Repetitive Motion and Overuse Injuries
They COULD break... but they don't.
Thankfully, our bodies know this, and so the spinal cord, lumbar spine, thoracic spine... everything... is supported and stabilized with surrounding muscles. These muscles form a protective shield and, since they are always in use, can be quite tight.
The problem?
Our muscles need rest.
A lot of physically demanding jobs are really only physically demanding for a few places on your body, requiring you to lift something heavy or be in an awkward position. And when that repeats over and over again, it can really wear out your upper back muscles
Muscles only grow stronger if they are given time to recharge. But with no breaks, you are basically letting them rip and tear and never repair again. These tiny tears lead to swelling and breaking down, rather than building up.
Of course... you can also "thrown out their back" in a moment! Medically, that is called a "muscle strain"; when a muscle is overwhelmed, it tightens and spasms, which causes intense pain. This can also happen to the muscles that are causing upper back pain, specifically the teres (minor and major), rhomboid (minor and major), and trapezius muscles.
"What if something is broken in there?"
If you straight up break your back like Bane broke Batman, you KNOW. But sometimes too much pressure on an individual vertebrae can cause tiny fractures in the bone. This might feel like sore muscles, but is actually much more serious, and requires x-rays to confirm.
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The Thoracic Spine and Occupational Injuries
While the thoracic spine is considered the middle of the spine, it is the source for most of upper back pain. Injuries to the bones and muscles in this area can be minor like pulled muscles or sprains but sometimes they're more serious such as slipped discs or even broken bones.
Identifying Symptoms of Thoracic Spine Injuries
Knowing when to spot signs of thoracic spine injuries allows you to get the right treatment early. While upper back pain is a usual sign, it's important to look out for other symptoms that might show there's a bigger problem.
With thoracic spine injuries, you might feel pain right in your upper back or sharp pains going along your ribs. You could also have numbness or a tingling feeling in your arms or legs, and even find it hard to move them as strongly as before. On top of this, if the injury messes with the nerves around there, you might start feeling pain spreading out from that area or notice weird sensations.
Other Common Thoracic Spinal Conditions
Herniated Discs: When spinal discs protrude or rupture, putting pressure on nearby nerves
Osteoarthritis: a form of arthritis that damages the protective cartilage between bones
Spinal Misalignment: When the joints of the spine are out of place. Fixing the problem often requires surgery, using screws and rods to keep the spine in place
Spinal Stenosis: When the spine does not have adequate space for the spinal cord and/or nerves, pinching them and causing pain
If you experience any of these symptoms happen to you, getting medical attention quickly is crucial so doctors can figure out why you're hurting and get started on helping you heal properly. Catching these issues early means less chance for more harm and helps speed up recovery.
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Frequently Asked Questions
How do I Catch it Early?
First and foremost, get tested BEFORE you start a physically demanding job, or ASAP. If you want workers compensation, you need to prove that you were healthy before you started working for your company. But if pain keeps getting worse over time...
DO NOT SHRUG IT OFF.
We can refer you to a physical therapist, who will guide you through the proper exercises, stretches and rest (alternating heat and cold packs). But if none of that helps, we will inform you on your available healthcare options.
How Can I Minimized Upper Back Pain?
There are braces you can get, and everyone loves those icy hot patches, but the real solution is good posture when you lift, push, pull, and yes even when you take a piss! Support your back with your core, shoulders rotated back, and stand up straight.
Even for older adults, it's not too late to minimize thoracic spine pain, lower back pain, and middle back pain with physical therapy and proper posture.
Are There Specific Stretches or Exercises Beneficial for Upper Back Health?
Many, but that will be a future blog post. For now, check out this post by Healthline.
When Should a I Seek Medical Attention for Upper Back Pain?
If the upper back pain prevents you from performing reasonable daily activities, like gardening, making dinner, or getting out of bed.
For example, if you have tried an ice pack and heating pad, and STILL you cannot perform your work duties as normal, or without taking copious amounts of pain killers... then you should see an occupational health specialist.
Other, more serious symptoms include a severe headache, feeling pins-and-needles in your chest or belly, having trouble moving smoothly, or getting hit by fever or chills.
Conclusion
If you are putting physical stress on your upper back day after day after day... without adequate rest or posture... then there is a good chance you will experience upper back pain. Whether it is a pinched nerve, neck pain at the base of your neck, compression fractures, or simply muscle fatigue, it deserves out attention
Before you come into our clinic, notice and record your pain:
When do you feel it?
It is a sharp or radiating pain?
How intense is it?
What activities make it worse?
What activities make it feel better?
The more accurate the answers you provide are, the better we can diagnose your condition and get you better ASAP.
