Upper And Middle Back Pain Causes

Most of the information you will find online about back pain is mostly about low back pain. This is because the pain in the lower back is more common- up to 80% of adults will experience at least an episode during their lifetime.  However, the upper and middle back can also affect many people. What are the underlying causes of this pain? Let’s review the most important ones in this article.

Neck pain causes 

There is a lot of pressure on the vertebrae of the neck because the neck supports the weight of the head. The spine in the neck area is very flexible and moves a lot. Therefore is prone to injuries- a lot more compared with the middle portion of the spine that works along with the ribs when the body is moving. 

Here are some of the most common causes of neck pain

  • Muscle strains and sprains. Due to modern  life, people spend countless hours  at the desk, sometimes cradling the phone between the head and shoulder. Improper posture makes muscle strains more likely, leading to neck pain. A strain or sprain in the neck area can also complicate with a herniated disc, causing weakness, numbness and tingling in the  shoulder and arm,along with pain.
  • Degenerative changes. Just like the lower back,  knees or other joints, the vertebrae in the neck area also degenerate as we age. Osteoarthritis and poor posture are the top causes of neck pain. Neck pain from osteoarthritis typically worsens with activity, especially when a person is upright, and may radiate to the arm and shoulders. Other symptoms may include numbness and tingling, a grinding sound when the neck is moving and headaches. Cervical spinal stenosis is another condition that can cause neck pain. It develops when the spinal canal becomes more narrow, affecting the spinal nerve root passages in the neck area. 
  • Injuries of the neck can be due to car accidents,  especially rear end accidents that cause whiplash injury. Some are mild and affect the muscles of the neck, others involve nerve irritation or damage, while in other cases the injuries can be severe and permanent. 
  • Inflammatory conditions. Rheumatoid arthritis and other inflammatory diseases. In case of rheumatoid arthritis, the neck pain and stiffness is worse in the morning and improves with the movement.  Other symptoms may include low grade fever, fatigue and rheumatoid nodules in the elbow and hands. Although rheumatoid arthritis is more common in women, men with positive rheumatoid factor  are more likely to have the upper spine (neck) affected. This condition has periods of flare ups and remissions. 
  • Infections. Meningitis can cause neck pain.  While viral meningitis are typically mild and clear on their own, bacterial meningitis can be life threatening.  Early symptoms mimic a flu. After several hours or a few days, meningitis causes painful, stiff neck ,  vomiting, severe headache, fever, lack of appetite, sensitivity to light, confusion and seizures.  Medical treatment is needed as soon as possible. 

Middle back pain causes 

The middle back is between the neck and lower back, where the thoracic spine and associated muscles and ligaments are located. While this part is less flexible and more rigid due to its connection with the ribs, it can still be affected by a few conditions that lead to pain in this area. The thoracic spine and the ribs help protect major organs such as the heart, lungs, and liver. 

  • Muscle strains and sprains may happen due to tears or overstretching the ligaments. For example, lifting heavy weights or making sudden movements can cause strains and sprains in the middle back. These muscle strains and sprains can also complicate with disc herniation,causing pain, tingling and numbness in the middle back and arms
  • Osteoarthritis. The most common form of degenerative arthritis is osteoarthritis. It is more likely seen in adults over age 40. Osteoarthritis affects the lower back more frequently, followed by neck pain and middle back.  The pain may radiate to the rib cage or the trunk of the body, causing difficulty  bending backward, walking or standing. Sitting in a chair for a longer period can also be difficult. 
  • Repetitive stress injuries (for example work related for someone who has to lift heavy loads) or sudden trauma from a fall or car accident can also involve the thoracic spine and cause middle back pain. 

How to manage  neck and middle back pain 

See a doctor if you experience upper or middle back pain, especially if the pain is persistent, worsens overtime or other symptoms develop. X-rays, CT scans, MRIs, EMGs, and blood tests may be recommended to find the underlying cause. 

You may have noticed that many of these causes can be prevented.  Neck and middle back pain can be treated with conservative treatments like rest, ice and/or heat packs, anti-inflammatory drugs and pain medications, steroid injections, braces, and physiotherapy. Surgery is recommended in selected cases, usually, when the pain is persistent, the nerve roots are entrapped. For mild pain, you can also use home remedies and supplements.

Prevention is always better than treatment. Check out this article for tips to prevent back pain.