How Do I Fix Mid-Upper Back Pain
Welcome “back” everyone (see what I did there)! Today we’re going to discuss the causes of mid-upper back pain as well as some things you can do to treat it. Pain in the mid back is another extremely common complaint we see. Pain in the mid-upper back can be particularly severe, and sometimes even make it difficult to breathe. There are occasions it may come on seemingly out of nowhere when you wake up in the morning, and then resolve within a week or two. Other times it may be a chronic problem that lingers around for years and years. In either case, it is NOT fun and can make it extremely difficult to do even the most mundane of tasks.
Symptoms of Mid-Upper Back Pain
There are typically two general presentations of this issue. Person number one is someone who feels tension throughout one or both sides of the area, often coupled with a similar feeling in the upper traps. They feel “stiff” and “tight.” Their muscles feel like rocks. They use stretches and massage guns for relief, but nothing ever permanently works. Its often worse in the morning, when they feel stressed out, or when they have a long day at work. This person will often say that they carry their stress in their neck or upper back. They may not realize they’re connected, but a lot of these people have headaches as well. Number two has one big, sharp knot that hurts like an absolute (your choice of expletive). The knots can be in a number of different places within the mid-upper back, most often surrounding the shoulder blades. They may be below the shoulder blade, just above it, right on it, right in between the blade and the spine, or just right smack in the middle of the back. I should also mention that more rare person, which is person number three. They’ve got all of the above descriptions combined into one singular stew of pain. Let me tell you, this is a tough way to be in. Fear not, however, as even this person DOES have hope.
Will Massage Work for my Mid-Upper Back Pain?
Yes and no. Massage or therapy guns WILL probably give you relief. The problem is that the pain will probably return some time soon. The tricky part about pain in the mid-upper back is figuring out the source. See, you may have a pain in your shoulder blade, but I can almost guarantee you that your shoulder blade is NOT the issue. That’s why you can massage that blade all you want, but the pain always seems to return. This is a cliche “bandaid” treatment. Typically, pain in the mid-upper back is usually what we call a “referred pain.” Referred pain can be described as a pain that occurs as a result of irritation at a different location in the body. An example of this would be a headache that stems from stiffness in joints of the upper neck. So if we know that the pain around the shoulder blade is NOT a shoulder blade issue, then where is it coming from?
What Causes Mid-Upper Back Pain
Every human body is also different. Because of this, sometimes it can be hard to identify exactly what the primary cause of a certain pain is. That being said, we can typically strip it down and identify a primary cause by using a really thorough physical examination. At our practice, we call this a “Total Body Diagnostic.” MOST of the time, pain in the mid back starts with irritation in one of the following areas:
- Thoracic spine: The thoracic spine is made up of the middle 12 spinal vertebrae. Irritation in the thoracic spine can refer sideways out into the areas surrounding the shoulder blades. Irritation here can also hurt right on the inflamed spot, which results in pain right down the center of your mid back.
- Lower portions of the cervical spine: The lower parts of the cervical spine are also very likely refer into the mid-upper back. See Figure 2 for referral patterns from the base of the neck (C7).
- Thoracolumbar junction: This is the area where the last segment of the thoracic spine meets the first segment of the lumbar spine. This area is prone to getting stiff, causing extra tension that can result in pain in the mid-upper back.
- Latissimus Dorsi: That’s right. The gold old “lat” muscle can actually refer pain into the shoulder blade region if it becomes irritated.
What Exercises Can I Do for Mid-Upper Back Pain?
Now that we know the most common areas that can cause pain in the mid-upper back, let’s go over what we can do about it. I’m going to provide one exercise for each region listed above. If they help you, GREAT! If not, it doesn’t mean therapy isn’t right for you, it just means you need a little bit more evaluation. Please use these exercises with some level of caution and proceed at your own risk.
Exercise to Treat the Lower Neck: Chin Retractions
Sit in a good posture in a chair and glide your head straight back as if you are trying to pull your face away from a slobbery dog. Your eyes should stay level as you move backward, and then back into neutral. If you feel pain as you move back, don’t push through it. Just stop shy of the pain and repeat 10x. Do this about 5 times through your day and see if you feel any better.
Exercise to Treat the Thoracic Spine: Thoracic Extensions
Sit in a good posture in a chair and fold your arms over your chest. Lean back over the top of the chair so that you feel a stretch in the upper part of your back, just below your neck, in the shoulder blade region. Be sure to keep your lower back pressed against the chair so that you do not feel the stretch happening down in your lower back rather than upper. Do sets of 10 multiple times throughout your day and see if this helps.
Exercise to Treat the Thoracolumbar Junction: Cat/Cows
This is a classic exercise and great for people with nerve tension in the bottom of the thoracic spine. For this exercise you want to position yourself on all fours. Lift your back up towards the ceiling, creating a “C” curve with your back. Then go back the other direction, arching your spine so that your belly button drops towards the ground. No need to hold for long periods, just comfortably move back and forth between the two positions. Do this 15-20x and try it 2-3x/day.
Exercise to Treat the Lat: Lat Pulldowns
You can use a machine to do the traditional lat pulldowns. You can also just tie a theraband to the top of a door frame, close the door, and then pull the band downward, out at your side with a straight elbow. Go to the point of fatigue and do three sets, once per day. That sums it up!! I appreciate you reading. If you or anyone you know have mid-upper back pain, or ANY OTHER aches and pains, please reach out and schedule your free consult today. We would love nothing more than to help you get back to doing what you love without pain! I hope this article was helpful! Be well, Dr. Trem