Upper Back Pain Treatment in Delhi, India

Upper back pain is a pain in the area between the base of the neck and the bottom of the rib cage. The upper back provides stability to anchor the rib cage and protect internal vital organs.

The upper back is relatively resistant to injury and pain. So when upper back pain occurs, commonly it is due to long-term poor posture or major injury. Severe upper back pain can limit physical activities; it feels like sharp burning pain at one spot on the back or general achiness that can spread to the neck, shoulder, and other body parts.

Types of Upper Back Pain

Upper back pain has two types. They are

• Muscular irritation: The shoulder girdle is attached by large muscles to the shoulder blade and back of the rib cage. These large muscles are prone to develop tightness and strain that can cause pain. Muscular irritation in the upper back occurs due to overexertion or deconditioning (lack of strength)
• Joint dysfunction: Joints of the thoracic spine can become dysfunctional due to ageing or sudden injury. This functionality can result in upper back pain

Symptoms of Upper Back Pain

Symptoms for upper back pain may differ from person to person. For some people, upper back pain can be mild and go away within days, and for others, the pain may worsen and interfere with daily activities.

Common symptoms of upper back pain include:

• Sharp and excruciating pain in the back
• Throbbing sensation or discomfort
• Soreness or stiffness
• Reduced mobility of upper back muscles
• Radiating pain in arm, neck, shoulder, or any part of the body
• Numbness or tenderness
• Weakness

Severe back pain can affect day-to-day activities, such as the ability to sit comfortably, lift moderately heavy objects, or stand for a long duration.

When to see a doctor?

In case of serious and persistent symptoms such as radiating pain, tingling sensation in the abdomen, and reduced coordination, consult the upper back pain doctor immediately.

Causes of Upper Back Pain

Other causes of upper back pain include:

• Poor posture: This can cause structural changes to the back and neck. The muscles may become weak and deconditioned
• Improper lifting posture: Lifting heavy objects without the correct posture can put stress on the upper back
• Accident: Vehicular accident, falling from a height, or any other kind of accident that can injure spinal bone or muscles and cause upper back pain

Upper Back Pain Diagnosis

Diagnosis for back pain includes:

• Patient's history: The doctor may ask about the complete medical history of the patient, including family history, onset of symptoms, the severity of back pain, lifestyle, and habits that may influence back pain
• Physical exam: Physical exam helps the doctor to evaluate the exact source of pain. The doctor may observe the back and the posture for anything unusual. He may also check for any tenderness, abnormality or rib instability
• Diagnostic tests: Imaging tests such as X-rays and MRIs can be performed. X-ray creates an image of the bones, while MRI creates a cross-section image of soft tissues and bones. This test helps the doctor to identify the exact source of pain
• Blood tests: Blood samples can be collected to test in a laboratory for infections or any abnormality that may point out to diseases such as arthritis or bone cancer

Upper Back Pain Treatment

The most common medical treatments for upper back pain include:

• Physical therapy: A physiotherapist can design a customised physical therapy program, including exercises and stretching, as per patients' specific needs. Physical therapy for back pain mostly focuses on stretching and strengthening the back, neck, and core muscles. This therapy can last for a few weeks or months
• Prescribed medication: In case of persistent pain, the doctor may advise prescribed medications. Commonly prescribed medications are nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, which prevent the pain signals from reaching the brain
• Injections: Spinal injections may be given to block the spinal pain. Epidural steroid injection is commonly given to reduce upper back pain. Such injections give short-term relief from the pain
• Surgery: Back Pain Surgery is rarely used for upper back pain. It is recommended if the spinal cord or nerve roots are at risk

Thoracic spine surgery is of two types:

1. Vertebral augmentation: This method is minimally invasive and uses artificial bone cement to stabilise the fracture and stop damaged bone's movement
2. Spinal decompression: This surgical procedure removes any structure, such as a herniated disc or bone overgrowth, that presses against the nerve or spinal cord. It relieves the pressure on the spinal cord

An alternative treatment available for upper back pain is complementary alternative medicine (CAM). Most people find alternative treatments effective that relieve the pain to some extent.

Complementary alternative medicine treatment includes:

• Acupuncture: Acupuncture is a treatment method in which thin needles are placed on the pain points to alter the energy waves, ease muscle tension and reduce pain
• Electrotherapy: Electrotherapy is a treatment method that elevates pain by sending small electric pulses to the pain points. Transcutaneous electrical nerve stimulator ( TENS) is a common electrotherapy that uses adhesive pads to place electrodes on the painful body part. This electrode creates a shooting and tingling sensation that reduces pain

Risk Factor of Upper Back Pain

Lack of physical fitness or exercise can increase the risk of upper back pain.

Other risk factors for upper back pain include

• Gender: Back pain is more common in women than in men
• Overweight: Being overweight can stress the back. Belly fat, particularly, can strain the soft tissues in the back, which can cause severe upper back pain
• Smoking: Smoking can reduce blood flow to the spine; this prevents the back from getting the necessary nutrients to stay healthy. It can cause the disc in the spine to degenerate, resulting in upper back pain

Prevention of Upper Back Pain

In most cases, upper back pain can be managed at home by taking a few preventive measures. Self-care, such as a good amount of rest, appropriate sitting posture, applying heat or ice on the back, and exercising, can help relieve the back pain.

It is also important to take regular breaks between work to stretch and walk around. Muscle strain from setting address can add to the poor posture, resulting in upper back pain.

Complication of Upper Back Pain

Upper back pain can lead to complications such as permanent nerve damage and physiological and psychological responses to chronic back pain.

Prognosis

The prognosis for lower back pain in terms of pain relief depends on the cause of the pain.

Most patients recover faster with medications and physiotherapy. Upper back pain gets better with time and exercise.

Review

Reviewed by Dr. Karan Baveja, Consultant, Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury and Dr. Yashpal Singh Bundela, Director - Neurosurgery, Neurosciences.