Upper and Middle Back Pain
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This topic provides an overview of upper and middle back pain. If you have low back pain or neck pain, see the topic Low Back Pain or Neck Pain.
What is upper and middle back pain?
Upper and middle back pain can occur anywhere from the base of your neck to the bottom of your rib cage.
Your ribs attach to a long, flat bone in the center of the chest called the sternum and attach to and wrap around your back. If a nerve in this area is pinched, irritated, or injured, you may also feel pain in other places where the nerve travels, such as your arms, legs, chest, and belly.
The upper and middle back (called the thoracic spine) has:
12 vertebrae. These bones attach to your rib cage. They make up the longest part of your back.
Discs that separate each vertebra and absorb shock as you move.
Muscles and ligaments that hold the spine together.
See a picture of the spine.
Upper and middle back pain is not as common as low back pain or neck pain, because the bones in this area of the back don’t flex or move as much as the bones in your lower back or neck. Instead, they work with the ribs to keep the back stable and help protect vital organs, such as the heart and lungs.
What causes upper and middle back pain?
Upper and middle back pain may be caused by:
Overuse, muscle strain, or injury to the muscles, ligaments, and discs that support your spine.
Pressure on the spinal nerves from certain problems, such as a herniated disc.
A fracture of one of the vertebrae.
Osteoarthritis caused by the breakdown of cartilage that cushions the small facet joints in the spine.
Myofascial pain that affects the connective tissue of a muscle or group of muscles.
In rare cases, pain may be caused by other problems, such as gallbladder disease, cancer, or an infection.
What are the symptoms?
Common symptoms of upper and middle back pain are:
A dull, burning, or sharp pain.
Muscle tightness or stiffness.
More serious symptoms that need to be treated right away include:
Weakness in your arms or legs.
Numbness or tingling in your arms, legs, chest, or belly.
Loss of bowel or bladder control.
How is upper and middle back pain diagnosed?
Your doctor will first ask you about your past health, your symptoms, and your work and physical activities. Then he or she will do a physical exam. Your doctor may also order an imaging test, such as an X-ray or an MRI, to find out if something such as a broken bone or a herniated disc is causing your pain.
You may need more tests to check for other possible causes for your pain.
How is it treated?
In most cases, people with mild to moderate back pain can manage their symptoms with:
Over-the-counter pain medicines , such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin).
Heat or ice.
Manual therapy , such as massage, mobilization, or spinal manipulation.
But if your pain gets worse and you’re having a hard time doing your daily activities, you may need to take a prescription pain medicine. Surgery is seldom used to treat upper and middle back pain.
How can you care for yourself at home?
There are several things you can do at home to help reduce your pain. For example:
Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly.
Use over-the-counter pain medicines, such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin). These can reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
Use a heating pad or ice pack. Heat can reduce pain and stiffness. Ice can help reduce pain and swelling.
Exercise. Exercises that stretch and strengthen the muscles in your back, shoulders, and stomach can help improve your posture, decrease your chance of injury, and reduce pain.
Practice good posture. Be sure to stand or sit tall. Don’t slump or slouch.
Learn ways to reduce stress. You might try deep breathing and relaxation exercises or meditation.
Upper and Middle Back Pain