Thoracic Back Pain/Upper Back Pain

Thoracic Back Pain / Upper back pain is a common symptom that can be caused by a range of lifestyle situations or conditions. While not as common as neck pain or low back pain, Thoracic Back Pain can still create problems on a daily basis.

Not surprisingly, this is because we are always using our upper back. Carrying groceries, driving, sitting at a desk, and injuries can all wreak havoc on our upper back, especially when repeated over and over. The good news is that you can quickly and conservatively remedy most causes of upper back pain. However, there are times when more in-depth treatment is needed to both treat the pain as well as any underlying condition. The Nevada Advanced Pain Specialists in Reno, Sparks, and Carson City dedicate themselves to helping their patients find relief from upper back pain and recommend options to prevent it in the future.

What is Upper Back Pain?

Upper back pain refers to any pain felt in the thoracic region of the back, which is the area of the back from the base of the neck to the bottom of the rib cage. While Thoracic Back Pain is not as common as other locations of pain in the back, it is important to treat the symptoms because the pain can become chronic if left untreated. 

Understanding upper back pain first begins with understanding the anatomy of the back and spine. The spine divides into five regions: cervical, thoracic, lumbar, sacral, and coccygeal, in order from top to bottom. The 33 vertebrae in the spine connect through ligaments. Intervertebral discs sit between each vertebra and help to provide a cushioning aspect between the vertebrae, as well as allow for flexibility. The adjacent ribs and muscles connect to the spine, which all work together to protect the organs (including the heart, lungs and liver) as well as keep the back stable. 

The Thoracic Region

The thoracic region of the spine, which begins at the base of the neck and continues to about six inches below the shoulder blades, is made up of 12 vertebrae. These vertebrae are medium-sized, larger than those in the cervical area but smaller than those in the lumbar area. Due to the fact that the thoracic back is in the middle of the spine area, and is widely used for all movements a person might do, any damage, injury or issue could lead to pain and limited mobility in the thoracic region as well as all regions of the back. 

What Causes Upper Back Pain?

The thoracic area of the back is incredibly helpful for providing stability to the back, and the body as a whole. The most common cause of pain in this specific area is myofascial pain syndrome. Myofascial pain syndrome is muscle pain due to injury or damage to the fascia, which is the soft stretchy connective tissue that surrounds muscles and organs. This can lead to chronic pain in the muscles throughout the body, in particular the upper back. 

The leading causes of chronic upper back pain most often include: 

Sprains and strains:

back sprains and strains are the most common reasons why a person will experience upper back pain. This could be due to lifting something too heavy or lifting something improperly that ends up causing damage to the muscles, tendons and ligaments in the upper back. 

Chronic poor posture:

not only can poor posture lead to upper back pain, but it can also exacerbate upper back pain symptoms. People who suffer from upper back pain often hunch over or stand crooked or bent. When the body’s natural posture is out of normal alignment for an extended period of time, this can cause structural issues as well as muscular issues. 

Disc issues:

bulging or herniated discs occur when a disc is out of its normal location in the spine, which can lead to irritation of the surrounding nerves. These conditions can be caused by trauma or by wear and tear over time. If left untreated, bulging or herniated disks can cause unbearable nerve pain that can lead to both a diminished quality of life as well as the need for interventional treatment. 

Fractures:

breaks or cracks in the vertebrae in the upper back, usually due to a traumatic incident, can lead to pain 

Arthritis:

osteoarthritis is the most common form of arthritis that causes upper back pain, and symptoms include swelling and tenderness over the affected vertebrae

Nerve inflammation:

if a nerve root becomes inflamed or irritated, symptoms can include stiffness, tingling, numbness or weakness

Spinal stenosis:

Narrowing of the spinal column can put pressure on the nerves in the spinal canal and those that branch off of it. Symptoms include back pain as well as tingling in the arms and legs. 

Thoracic facet joint pain:

An arthritis-like condition of the spine that is caused by degenerative changes to the joints between the bones of the spine. When the cartilage inside the facet joints break down and become inflamed, nearby nerve endings send pain signals to the brain. 

What Does Upper Back Pain Feel Like?

Just as there are a variety of reasons why a person might experience upper back pain, there are a variety of ways that a person could experience upper back pain. The most common complaints include: 

• Tightness or stiffness in the muscles 
• Tingling, weakness or numbness
• Achy, throbbing pain
• Burning or sharp pain

In addition to pain felt in the upper back, pain can also radiate to other areas of the body including the arm, chest and abdomen. Pain can also be consistently present, or can come and go. Some patients report feeling pain early in the morning after being still during sleep, while others experience pain at the end of the day after they’ve been mobile. 

We can categorize back pain as acute or chronic. Due to the fact that the thoracic region of the back protects vital organs, it is imperative to seek medical attention when pain is felt as there could be an emergency issue at hand, especially if the pain is sudden and intense. Chronic pain is pain that lasts for at least three months, and often longer. Those who suffer from chronic upper back pain can suffer from any of the aforementioned conditions, but also gastroesophageal reflux disease and even pulmonary illnesses. It’s important to recognize your specific level and duration of pain so that the best and most effective treatment option can be utilized. 

How is Upper Back Pain Diagnosed?

The best way to properly and accurately diagnose upper back pain is to partner with a trained pain management specialist. Also, it’s important to pay attention to your feelings of back pain as they could be the signal that you are suffering, or have suffered, from another medical condition. 

To understand your particular cause of upper back pain, your healthcare provider will perform a physical exam, and learn about your current medical history as well as your family history. Imaging tests are also helpful for determining the cause of pain as they provide the provider with an in-depth look into the body. These imaging tests include X-rays, MRI or CT scan and are helpful for providing pivotal information in regard to any possible trauma or damage to the spine or surrounding soft tissues. 

In addition to an exam and imaging tests, your provider will ask you questions to get a better idea of your specific pain symptoms. These can include: 

• When did you first experience pain in your upper back? 
• Where in the upper back do you feel the pain the most? 
• Is there anything you’ve done to successfully decrease pain symptoms?
• Is there any activity or situation that makes the pain worse?
• What does the pain feel like? 
• When do you most often feel the pain?
• How long does the pain last for?

Once your provider has a diagnosis, they will recommend a treatment plan to help you get out of pain as comfortably and quickly as possible. This generally includes beginning with at-home and conservative treatment options first before moving to invasive and surgical options. 

What are the Best Treatments for Upper Back Pain?

The great news is that there are several conservative treatment options for remedying upper back pain, all of which are dependent upon each person’s specific causes and symptoms of pain. Most healthcare providers begin with the most minimally-invasive options first with a goal to provide pain relief in the most comfortable way possible, with also the least amount of risks and chance for complications. Your pain management specialist will be able to recommend a treatment plan tailored to your specific cause of upper back pain as well as your desired quality of life. The most effective treatment options for upper back pain include:

• Lifestyle changes: focusing on proper posture techniques, maintaining a safe and active workout regimen, and enjoying a healthy diet all help to reduce added stress on the upper back. Enjoying a physical therapy routine can also strengthen the upper back so that potential future upper back stressors can be avoided. 
• Alternative therapies: yoga, acupuncture, massage and chiropractic care for strengthening core and key muscles, realigning the spine, and reducing stress, all of which have proven helpful for providing upper back pain relief
• Medications: NSAIDs, over-the-counter and prescription medications, including muscle relaxants, steroids and membrane-stabilizing medications are helpful for treating acute cases of upper back pain. Taking pain medications, as prescribed, has also helped patients more comfortably enjoy additional therapies, such as exercise or physical therapy.  
• TENS therapy: transcutaneous electrical nerve stimulation (TENS) uses low voltage electrical currents at or near the affected nerves to block or change the brain’s perception of pain. An added benefit is that the patient is able to control the level of stimulation, so can increase or decrease the electrical current as needed. 

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• Medial branch blocks (MBBs): Doctors use medial branch nerve blocks to diagnose pain caused by damaged or inflamed facet joints in the spine. The injection includes an anesthetic and possibly a steroid that helps to reduce inflammation and pain. If a medial branch block proves helpful, additional treatment options could be utilized to provide more long-term pain relief. 
• Epidural steroid injections: most often used to treat degenerative disc disease and other pain syndromes, epidural steroid injections involve an injection of an anesthetic and a steroid into the epidural space in the spine with the goal to decrease inflammation and pressure on the affected nerves
• Facet joint injections: these injections involve the placement of medication (usually anesthetic and a steroid) directly into the facet joint. Most patients experience immediate pain relief as well as improved range of motion. 
• Surgery: When all other pain relieving methods have failed, surgical options might be needed to provide the patient with needed chronic upper back pain relief. Most often, surgeries for upper back pain involve removing what’s causing the pain (decompression surgery) or fusing the spine to control movement (spinal fusion). Additional surgeries include vertebrectomy, discectomy, laminectomy and more. 

The best way to solve your upper back pain conditions is to first understand and recognize what is causing the pain in the first place, and then to utilize the best and most effective treatment options for remedying the pain conditions now as well as avoiding any additional conditions in the future. 

While there are no guaranteed ways to avoid upper back pain, there are some steps a person can take to minimize their chance of experiencing pain symptoms. These include using exercise methods to stretch and strengthen the muscles in the upper back, practicing good posture, and reducing stress with breathing, meditation and relaxation exercises. 

If you are suffering from acute or chronic upper back pain and would like a solution, please schedule an appointment with the Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas today. Our team is well versed in all causes and conditions that might cause upper back pain, as well as the best treatment methods to help a person experience pain relief now and in the long term.