What Causes Upper Back Pain?

There are a variety of reasons for upper back pain. In terms of location, we’ll be referring to the thoracic spine, from the area just below the tips of your shoulder blades to the lower portion of where your neck meets your upper back area. In this anatomical area, there are essentially five physical structures that have the ability to produce the symptoms you are experiencing. These five are: bones, muscles, ligaments, tendons and nerves.

The Bones
In this particular area, we are really looking at the bones of the spine – the vertebrae – as the primary bony structure. There is also your ribs and scapula or shoulder blades. Bones may cause pain from a few different means. They could be fractured or broken, due to trauma or osteoporosis. The outer membrane of bone is highly pain sensitive, so you would feel pain if this were the case. Tumors within the bone can also cause pain as the outer membrane is either stretched or eaten away.

The Muscles
Muscles are a very common reason for pain. They can be over-worked, stretched, strained, have trigger points or spasms. There are a variety of muscle groups in the upper back region; paraspinal muscles – both larger and deeper postural muscles around the spine, trapezius, lattissimus, rhomboids to name a few.

The Ligaments
The ligaments are tissues that are responsible for holding your bony structures to one another. They act like the ‘glue’ that holds your bones in close contact with one another so that your muscles can perform their function. Ligaments can be sprained and cause pain and inflammation, often due to trauma. This ‘trauma’ could be in the form of prolonged postural stress or injury from exercises or stretching, even yoga.

There are also great stretches or asanas in yoga for upper back pain. Many of these 2,000+ year old postures are similar to what current practitioners offer their patients. These are typically extension-based exercises and stretches that tend to open the anterior (front) part of the chest, while having the upper back curve back as if you were curling your head and neck back.

The Tendons
Tendons are the parts of the muscle that attach to the bones. The tendon has special receptors that act as regulators of how much tension is being placed on the muscle and will cause a muscle to shorten or allowed to be stretched. Sometimes, the feedback that the muscles are getting from these receptors or the nerve itself will cause the muscle to spams or tighten. Muscles spasms and focal trigger points can also create pain locally or cause more diffuse or referred pain to another region of the body or limbs. Many times, this type of pain can mimic a disc herniation or radiating pain from a compressed nerve.

The Nerves
Your nerves are what convey the messages throughout your body. They are what relay information from your senses to your brain and then send the ‘decoded’ message back to the appropriate body part for proper function. This is why as chiropractors, we are keenly interested in the proper flow of information through the nerves and nervous system.

The nervous system consists of the central and peripheral aspects. The brain and spinal cord make up the central part and the nerves that go to all your cells, tissues, organs and limbs make up the peripheral aspect. Both are extremely sensitive to changes in tension or stress.

In fact, research done in the latter part of the 20th century by neuro-scientist Alf Brieg, M.D. showed that significant detriment to neurological function (and perception of pain) is created by tension from the central nervous system.

He showed that the anatomical structures of the anchoring system where the spinal cord tissue meets the bones of the spine can translate a mechanical force or tension to the nerve tissue. His models showed how adverse mechanical cord tension can lead to a variety of neurological implications.

So, where does all this leave you? You probably just have pain in your upper back and want relief. If you work in an office job or sit in front of a computer much of the day, which many of us do, then you are likely creating some postural stresses. These can be alleviated – IN PART – by making appropriate ergonomic changes to your work station.

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This image shows the base of the skull and upper neck, an area that can be compressed by postural stress and upper back pain.

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However, much of posture is an automatic or autonomic process. That is to say, it is affected more by the unconscious way in which your nerves are relaying information to your muscles about how they should be functioning. Tension that is not dissipated from the nervous system will lead to structural changes in your posture. This will, eventually, lead to a shortening of muscles and further structural changes to the bones of your spine.

Much of your upper back pain can be addressed by a series of care at your chiropractor. There are a variety of methods to care for spinal cord tension. Our office utilizes Network Spinal Analysis as the main system by which we assess for this tension. Then, through a very gentle approach, help your body dissipate the tension, allowing you to feel more at ease, breathe deeper and feel lighter, overall.

If you’d like to experience the benefits of Network Chiropractic or learn more about how our office may be able to help you with your upper back pain, contact us today to get started. We look forward to working with you!


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