What is thoracic or upper back pain?
By Dr El Toukhy

You’re not alone if you’ve ever experienced upper back pain; it can be a sign of thoracic spine pain. Thoracic pain can range from mild to extreme, affecting individuals of all ages and lifestyles. 

Our pain management expert, Dr El Toukhy, is here to shed light on this common ailment and provide invaluable insights into its causes, symptoms, and effective treatment options. 

An Overview of the Thoracic Spine

The thoracic spine, also known as the upper or middle back, is crucial in providing stability to the rib cage and guard vital internal organs in the chest. While the cervical and lumbar regions of the spine are more flexible, the thoracic spine has a restricted range of motion owing to its connection to the rib cage. 

The thoracic spine consists of 12 vertebrae, labeled T1 through T12, located beneath the neck and extending down the back of the torso. Unlike the cervical and lumbar spines, the thoracic spine is relatively immobile due to the connection of each vertebra to a pair of ribs, which, along with the sternum, form the rib cage. This design provides stability and protection to the vital organs within the chest.

Recognizing the causes of Upper Back Pain

Upper back pain can be attributed to various factors, including muscular irritation and joint dysfunction.

Muscular Irritation: The upper back is susceptible to muscular strains and tightness, especially in the large muscles attached to the shoulder blade and the back of the rib cage. This type of muscular irritation is often caused by de-conditioning, a lack of strength, and overuse injuries resulting from repetitive motions.

Joint Dysfunction: Dysfunction in the thoracic spine joints can lead to pain and discomfort. This dysfunction can occur due to sudden injuries or natural degeneration associated with aging. For example, tearing the cartilage or joint capsule in a facet joint can cause joint dysfunction and subsequent pain.

Some of the other common causes may include:

Poor Posture: Prolonged sitting or slouching can strain the muscles and ligaments in the upper back, causing pain and muscle imbalances.

Injury or Trauma: Accidents, falls, or sports-related injuries can cause sprains, strains, or fractures in the upper back, leading to pain and discomfort.

Herniated Discs: When the soft discs between the vertebrae in the upper back become damaged or bulge, they can press on nerves, causing pain.

Osteoarthritis: Age-related wear and tear can affect the joints in the upper back, leading to inflammation, pain, and reduced mobility.

Stress and Tension: Emotional and psychological stress can cause muscle tension in the upper back, resulting in pain and discomfort.

Decoding the Symptoms: Recognizing Thoracic Spine Pain

Some of the common symptoms of upper back pain are:

• Constant Upper Back pain: Dull, aching, or sharp pain localized in the upper back region is a common symptom of thoracic spine pain. The pain may be persistent or intermittent and can vary in intensity.

• Limited Range of Motion: Thoracic spine pain can lead to stiffness and reduced flexibility in the upper back. You may experience difficulty with certain movements or feel a sense of tightness in the area.

• Radiating Pain: In some cases, thoracic spine pain can radiate to the chest, abdomen, or arms. A tingling sensation or numbness may accompany this pain.

• Muscle Tension and Spasms: The muscles surrounding the thoracic spine may become tense and develop spasms, causing additional discomfort and restricted movement.

• Postural Changes: Thoracic spine pain can affect your posture, leading to a forward slouching position or a hunched back to alleviate pain. This altered posture may exacerbate the pain over time.

• Pain while Breathing: Thoracic spine pain can be aggravated by deep breathing or certain movements involving the ribcage, causing discomfort or sharp pain.

• Tenderness in Spine: The thoracic spine may feel tender to the touch, and pressure on specific areas may worsen the pain.

Diagnosing Thoracic Spine Pain with Precision

Various imaging tests may be recommended to visualize the thoracic spine and identify any abnormalities or structural issues. These may include:

• X-rays: X-ray images can provide a basic view of the bones in the thoracic spine and help identify fractures or other bony abnormalities.

• MRI (Magnetic Resonance Imaging): MRI scans use powerful magnets and radio waves to give out detailed images of the thoracic spine’s soft tissues, discs, and nerves. This can help identify herniated discs, spinal cord compression, or other soft tissue abnormalities.

• CT Scan (Computed Tomography): CT scans provide detailed cross-sectional images of the thoracic spine, allowing for a more comprehensive evaluation of the bones, discs, and nerves. This can be particularly useful for detecting fractures or evaluating complex spinal conditions.

Unlocking Relief: effective strategies to ease upper back pain

The treatment approach for thoracic spine pain relies on the condition’s severity and underlying cause. In many cases, self-care measures can help manage the pain. These measures may include rest, improving posture, and applying ice or heat to the area. However, additional treatments may be necessary if the pain persists or worsens.

Medication: Over-the-counter pain relievers, like nonsteroidal anti-inflammatory drugs (NSAIDs), may temporarily relieve thoracic spine pain. In more severe cases, prescription medications, including muscle relaxants or opioids, may be prescribed to manage upper back pain.

Physical Therapy: Physical therapy is a personalized exercise program to strengthen the muscles supporting the thoracic spine and improve flexibility. Physical therapy may also include techniques such as manual therapy and postural correction.

Interventional Procedures: In some cases, minimally invasive interventional procedures may be recommended to alleviate thoracic spine pain. These procedures may include injections of local anesthetics, steroids, or nerve blocks to target specific sources of thoracic spine pain.

Alternative Therapies: Complementary and alternative therapies, such as acupuncture, chiropractic care, or massage therapy, may also be considered part of a comprehensive treatment plan for thoracic spine pain.

Knowing When to Seek Help: Red Flags and Urgent Cases

While most cases of thoracic spine pain are not indicative of a severe underlying condition, there are instances where immediate medical attention is necessary. 

• If the pain is accompanied by radiating pain or needles-like tingling in the abdomen or chest, fever or chills, hindered coordination, difficulties in walking, or severe headaches. In that case, it is essential to seek medical treatment promptly. 
• If the pain follows a high-impact event, such as an auto accident or fall. In that case, it should be evaluated by a professional to rule out any potential injuries or complications.

Consult Dr El Toukhy for expert pain management

Dr El Toukhy, a specialist in pain management, emphasizes the importance of finding the root cause of pain and implementing a uniquely-tailored treatment plan for each individual. 

With Dr El Toukhy’s technologically advanced interventions help patients with chronic pain avoid surgery and regain their quality of life.

Book your appointment today!