Upper Back Pain Treatment in Delhi, India

Thoracic spine pain is of two types. They are:

1. Muscular Spasm: The shoulder girdle is attached by large muscles to the shoulder blade and back of the rib cage. These large muscles are prone to develop tightness that can cause pain. Muscular irritation in the upper back occurs due to overexertion or deconditioning (lack of strength).
2. Joint dysfunction: Joints of the thoracic spine can become dysfunctional due to ageing or sudden injury.

Symptoms for upper back pain may differ from person to person. Common symptoms of upper back pain include:

• Sharp and excruciating pain in the back
• Throbbing sensation or discomfort
• Soreness or stiffness
• Reduced mobility of upper back muscles
• Radiating pain in the arm, neck, shoulder, or any part of the body
• Numbness or tenderness
• Weakness

Severe back pain can affect day-to-day activities, such as the ability to sit comfortably, lift moderately heavy objects, or stand for a long duration.

In case of serious and persistent symptoms such as radiating pain, tingling sensation in the abdomen, and reduced coordination, consult the doctor immediately.

Other causes of upper back pain include:

• Poor posture: This can cause structural changes to the back and neck. The muscles may become weak and deconditioned.
• Improper lifting posture: Lifting heavy objects without the correct posture can stress the upper back.
• Accident: High-velocity vehicular accident, falling from a height, or any other accident that can injure spinal bone or muscles and cause upper back pain.

Diagnosis for back pain includes:

• Patient's history: The doctor may ask about the patient's complete medical history, including family history, the onset of symptoms, the severity of back pain, lifestyle, and habits that may influence back pain.
• Physical exam: Physical exam helps the doctor to evaluate the exact source of pain. The doctor may observe the back and the posture for anything unusual. They may also check for any tenderness, abnormality, or rib instability.
• Diagnostic tests: Imaging tests such as X-rays and MRIs may be performed. X-ray creates an image of the bones, while MRI creates a cross-section image of soft tissues and bones. This test helps the doctor to identify the exact source of pain.
• Blood tests: Blood samples can be collected to test in a laboratory for infections or any abnormality that may point out to diseases such as arthritis or cancer.

The most common medical treatments for upper back pain include:

• Physical therapy: A physiotherapist can design a customized physical therapy program, including exercises and stretching, as per patients' specific needs. Physical therapy for back pain mostly focuses on stretching and strengthening the back, neck, and core muscles. This therapy can last for a few days to weeks.
• Electrotherapy: Electrotherapy is a treatment method that elevates pain by sending small electric pulses to the pain points. Transcutaneous electrical nerve stimulator ( TENS) is common electrotherapy that uses adhesive pads to place electrodes on a painful body part. This electrode creates a shooting and tingling sensation that reduces pain.
• Prescribed medication: In case of persistent pain, the doctor may advise prescribed medications. Commonly prescribed medications are nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants, which can alleviate a patient's discomfort.
• Injections: Spinal injections may be given to block the spinal pain. Epidural steroid injection is commonly given to reduce acute pain and discomfort.
• Surgery: Surgery is rarely done for upper back pain. It is only recommended if the spinal cord or nerve roots are at risk. Thoracic spine surgery is of two types:

• Vertebral augmentation: This method is minimally invasive and uses artificial bone cement to stabilize the fracture.
• Spinal decompression: This surgical procedure is indicated in cases such as a herniated disc or bone overgrowth that compresses the nerve or spinal cord. It relieves the pressure on the spinal cord.

Lack of physical fitness or exercise can increase the risk of upper back pain. Other risk factors for upper back pain include:

• Gender: Back pain is more common in post-menopausal women than men.
• Overweight: Being overweight can stress the back. Belly fat, particularly, can strain the soft tissues in the back, which can cause severe upper back pain.
• Smoking: Smoking can reduce blood flow to the spine; this prevents the back from getting the necessary nutrients to stay healthy. It can cause the disc in the spine to degenerate, resulting in upper back pain.

In most cases, upper back pain can be managed at home by taking a few preventive measures. Self-care, such as a good amount of rest, appropriate sitting posture at work, applying heat or ice on the back, and exercising, can help relieve the back pain.

Taking regular breaks between work to stretch and walk around is also important.

Upper back pain can lead to complications such as permanent nerve damage and physiological and psychological response to chronic back pain.

The prognosis for upper back pain in terms of pain relief depends on the cause of the pain. Patients recover faster with medications, physiotherapy and the precautions advised by the doctor. Upper back pain gets better with time and exercise.

Reviewed by Dr. Karan Baveja, Consultant, Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury on 02-May-2023.

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