Upper Back Pain Causes

Upper back pain is back pain that is felt in this part of the back and is usually associated with injuries in the thoracic spine or the other structures in the chest cavity. The upper back, also known as the mid-back or middle back begins at the base of the neck - at the first thoracic vertebra (T1), and ends just above top of the lower back, at the 12 thoracic vertebra (T12). While the cervical spine (neck) and lumbar spine (lower back) are more mobile and flexible in order to allow for movement, the primary purpose of the thoracic spine is support and stability. Thus part of the spine makes up the back wall of the thoracic cavity which houses the heart, lungs and pulmonary vessels. Because the thoracic spine moves to little, back conditions such as degenerated discs and herniated discs are not as common as would occur in the cervical and lumbar spine. More often, upper back pain causes include joint dysfunction, moyfascial pain (muscular irritation), and the spinal abnormality of Kyphosis (Dowager's Hump) associated with bone density loss.

Finding the cause of back pain is usually very difficult because they don't usually involve structural abnormalities that are obvious on medical imaging tests such as the X-Ray, MRI, and CT Scan. These causes aren't typically obvious on medical images or any of the other radiographic tools currently available.

Upper Back Pain Causes
Joint Dysfunction: The joints of the thoracic cavity include the discs that provide a cushioning between the vertebral bodies, the facet joints, and the articulations between the thoracic vertebra and the ribs. The thoracic vertebrae make up the posterior wall of the thoracic cavity and posterior ends of all 12 ribs. The ribs connect to the thoracic vertebra at two joints: the joints of the head of the ribs and the costotransverse joints. Two parts of the rib connect to the vertebra: the head and the tubercle. The head of the rib connects to the sides of the vertebral body. The tubercle connects to the transverse process. The joints where the two structures join are synovial joints. These Synovial joints in the T-Spine allow for sliding or gliding motions as we breathe in and out.



Upper back pain may be caused by dysfunction in these joints. Dysfunction in these joints may be related to either hypermobility or hypomobility of these joints. Hypermobility means that these joints allow for two much motion - possibly causing pain. Hypomobility mains too little motion in these joints - which could also cause pain. If the cause of upper back pain is related to the motion of the joints, or dislocation, then the best treatment may be manual manipulation to restore function.

Manual manipulation of these joints may be performed by chiropractors, osteopathic physicians, and sometimes by physical therapists. Medical images such as X-Rays, MRIs, and CTs are very good at showing thoracic herniated discs, and obvious signs of joint dysfunction. These medical images, though, may not present subtle joint dislocations which aren't plainly visible but are nonetheless the cause of the patient's symptoms. the manual manipulation therapist may use his or her hands to feel for joint dysfunction, and he or she may use his or her hands and body to move the joints back into their proper position. This type of joint manipulation is also known as joint mobilization.

Muscle Irritation as a Cause of Upper Back Pain: the large muscle groups in the upper back connect from the back of the thoracic rib cage to the scapula of the shoulder girdle. The shoulder girdle includes the proximal humerus (upper arm), scapula, and clavicle (collar bone). The shoulder girdle is involved in the movements of the upper arm, breathing, and the movement of the shoulder. These large muscle groups may be vulnerable to irritation when we work while using bad posture, repetitive stress injuries, and overloading. Pain may be felt due to irritation of the muscle tissues themselves, or the myofascia which lines the muscle surfaces. Myofasical pain may originate due to an obvious injury but may linger far longer than it should and the tissues around them have healed.

To stimulate the healing of the myofascia, viable treatments include acupuncture, massage therapy, osteopathic and chiropractic manipulation, and physical therapy. Most physical therapy programs that involve the large muscles in the shoulders include a comprehensive program of strengthening and stretching exercises.