To better understand the possible causes of upper back pain, let’s first examine the structure of the spine. The adult spine consists of twenty-four stacked vertebrae atop the sacrum of the pelvis and the coccyx or tailbone. The upper back, while not an anatomically distinct part of the spine, usually refers to the upper thoracic spine just below the cervical spine or neck. It also includes the upper ribs which articulate to the thoracic vertebrae and encircle the torso to protect the precious organs beneath it.

Along with the bones of the thoracic spine, upper back pain may involve the scapula (shoulder blades) or one of the many muscles that lie over this area. These muscles are in charge of moving and controlling the spine, the scapulae and the upper extremities. Let's not forget the fascia and nerves that wind between the muscles and bones of the upper back.

Upper back pain can be the result of injury, irritation or inflammation to any of the structures located in this area. Here are some common causes of upper back pain that we see here in our clinics:

• Strained muscles.
• Tight or restricted muscles or fascia.
• Stiffness or pain where the ribs meet the spine.
• Intervertebral disc herniations (much less common than in other areas of the spine).
• Numbness or tingling in the neck, shoulders, arms, hands, hips, legs, or feet.
• Osteoarthritis.
• Bone spurs.
• Referred pain from the neck.
• Stiffness or decreased mobility in the spine.
• Postural dysfunction.
• Breathing dysfunction.
• Errors in movement and biomechanics.

HOW DOES UPPER BACK PAIN PRESENT?

• Aching, burning, sharp or dull pain in the upper part of the back below the neck
• Pain on either side of the spine between the scapulae
• Back or rib pain with coughing or deep breathing
• Muscle tightness or difficulty turning the head or torso or bending forward
• Pain over or near the thoracic spine itself
• Muscle pain near the thoracic spine
• Feelings of stiffness and tightness in the area of the upper back

If you decide to work with a physical therapist to help correct your upper back issues, your entire treatment plan could consist of around 8-20+ different physical therapy for back pain sessions that will each last 60-90 minutes. Once you complete your customized back pain physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your back pain PT sessions yet in the comfort of your own home.

HOW DO PHYSICAL THERAPISTS ADDRESS UPPER BACK PAIN?

The goal of physical therapy treatment for upper back pain is to relieve symptoms while addressing any underlying or contributing factors that may predispose you to recurrence or progression of your pain. As mentioned above, my team and I will create an individualized treatment plan based on your unique presentation and the findings of our exam but here are some treatments commonly used to manage pain or discomfort in the upper back:

Reduce pain, inflammation and irritation:While completely eliminating your symptoms may take time, making you more comfortable in the meantime is an important first step in your rehabilitation. Applying ice or heat, ultrasound or electrical stimulation to the affected area can often give you some relief. Soft tissue mobilization or gentle joint mobilization may also be employed by your physical therapist to reduce tissue irritation.

Improve flexibility:When a joint lacks the flexibility needed to perform a movement optimally, extra stress and strain may occur in the spine. Your back PT program may include stretching, myofascial release techniques, joint mobilization and mobility exercises to improve flexibility in the back itself but also in other areas of the body such as the hips, neck and shoulders.

Build up your strength:Just as lack of flexibility around joints of the arms and legs can lead to pain or tightness in the back, lack of strength and stability can too. You will learn exercises to help strengthen the muscles around the back, neck and abdomen to properly control the spine and also in the arms and legs to minimize excess strain transfer to the back.

Optimize your movement: Learning proper biomechanics and enhancing the neuromuscular control of joints and muscles is an essential component of healing and preventing back injuries. Physical therapists are movement experts and through analyzing your movements, can guide you in improving how you move and train your muscles to perform those movements in the safest and most effective way possible.

If you are dealing with upper back pain and ready to find long-lasting solutions to your symptoms call us today to learn more about our services and schedule an evaluation: