Upper back pain, though not given due attention, is as common as that of the lower back pain which afflicts a sizable chunk of the population. It is often brushed aside as that bothersome pain in the neck. However, the pain and discomfort does impact the quality of life of those affected by it and can, over time, impact day-to-day activities. Medical intervention in the early stages will prevent the pain from radiating and intensifying over time, say experts.
“People start developing a nagging upper back pain with prolonged sitting. The shoulder starts to droop as well,” says Dr Raghu Nagraj, director, orthopaedics, Fortis Hospital, Bangalore.
“As a result, sleep gets disturbed and the muscles in the upper back and shoulders become sore, when one wakes up,” adds Dr Nagraj. “But the pain is not as debilitating like the lower back pain. In upper back pain, one will be able to manage the day-to-day activities [initial stages]. Hence there is a reduced reporting of it.”
Identifying upper back pain
People often confuse neck pain or cervical spine pain with pain in the upper back. But they are different.
“Upper back pain is mostly around the neck and upper back junction area and the thoracic region, which also includes the scapula or the shoulder blades,” says Dr Nagraj.
However, depending on the cause, upper back pain can also be felt as a pain radiating from the neck to the upper back region.
“For instance, when there is nerve compression or a cervical slip disc in the neck region, that can give rise to pain in neck which spreads and radiates to the upper back,” adds Dr Nagraj.
“Sometimes people come complaining about neck pain but then on diagnosis it is confirmed as upper back pain,” says Dr Rewat Laxman, senior consultant orthopaedics sports injury and joint replacement, Manipal Hospitals, Bengaluru. “When people have a pulled muscle in the upper back, the pain radiates from the base of the neck until the tip of the shoulder blade and moves sideways towards the shoulder on the top. It is a boomerang shaped area around the upper part of the back, where one can feel the distribution of pain.”
Many causes of upper back pain
The pain in the upper back can stem from many factors. Some of the common causes are listed below:
- Improper posture: Sitting in an improper posture is one of the major causes. It is quite common in working professionals who spend long hours working on a computer. “The drooping shoulders, while sitting in improper posture causes the upper back pain,” says Dr Nagraj.
- Improper pillow height: Using a thin pillow is ideal. “Thin pillows help maintain the right neck posture while sleeping as they bridge the gap between the head and shoulder while making sure they are in line,” says Dr Laxman.
- Fibromyalgia: If the trigger points of fibromyalgia are at the shoulder blades, then that can cause pain too. “In fibromyalgia, the muscle spasms will be more in the scapular or shoulder blade muscles, which happen because of poor posture while working or an unhealthy lifestyle – not doing regular exercise or lack of shoulder movement. Thus, the muscles become weak and become irritable trigger points which cause pain in the upper back. Sometimes vitamin D deficiency and vitamin B 12 deficiency can give rise to fibromyalgia too,” explains Dr Nagraj
- Osteoporosis: It is a condition that is commonly seen in the elderly, especially in women. “When calcium levels and the bone mineral density drop – osteoporosis also gives rise to upper back pain,” says Dr Nagraj.
- Slipped disc: When one of the spinal discs protrudes out, it results in slipped disc. “If the nerve that is involved in the cervical slip disc is travelling to the upper back, then there is pain,” says Dr Nagraj.
- Rotator cuff injury: Rotator cuff is a group of muscles and tendons that surround the shoulder joint. “Rotator cuff tears or impingement of the rotator cuff can send a shooting pain to the scapula, spine or upper back region,” says Dr Nagraj.
Tackle pain in the upper back with ease
To treat pain in the upper back region, a clear examination of the pain is crucial. Palpation of the shoulder blades helps to identify the pain trigger. There are some simple measures that one can take to prevent or treat the pain.
“Measures include regular exercises to strengthen the neck and upper back muscles,” says Dr Nagraj. “While doing a desk job, make sure to keep the back upright and straight (soldier) position and don’t let the shoulders droop. While looking from the side, the shoulders should be in line with the chest and not in front of it. Ergonomically designed chairs in which the back support come up till the upper back should be used,” says Dr Nagraj.
Checking vitamin D and vitamin B12 levels and maintaining the required levels will keep the muscle and the bone quality good and prevent the pain.
“But if one is already experiencing upper back pain, then use a hot water fomentation in a chronic case and a cold pack, if the pain is acute,” says Dr Nagraj.
Using pain relieving sprays can also help manage the pain. “I would suggest using sprays instead of creams and not mixing or [rubbing] after using the pain relief spray,” says Dr Laxman while emphasizing that upper back pain is seen mostly in working professionals who should not ignore the symptoms and attend to it as early as possible, so that the stress is reduced, and productivity is not affected.
Takeaways
- Upper back pain is commonly confused with neck pain, but they are not the same and can be easily differentiated. However certain conditions in the neck region such as cervical slipped disc or a pinched nerve can give rise to pain in the upper back.
- Poor lifestyle, improper posture, inaccurate pillow height, fibromyalgia, osteoporosis, and rotator cuff injury etc are some of the causes of upper back pain.
- Upper back pain can be prevented by maintaining the right posture, doing regular neck and shoulder strengthening exercises. The pain can be managed with stretching exercises, hot fomentation, and cold pack or even by using pain relief sprays.
