Symptoms And Causes Of Back Pain
Symptoms
You may experience upper back pain as localized tightness, throbbing, aching or sharp pain in the thoracic area of your back or in your neck. It can also be experienced as radiating pain in your arms, numbness, tingling or weakness in your arms, headache, or pain in your jaw or occipital area. Because the ribs are attached to the thoracic spine, you may also feel pain when taking a deep breath.
Causes
The common causes of upper back pain stem from inflammation and micro-tears in the muscles, tendons and ligaments of the upper back or from arthritis, herniated disks, vertebral stenosis, or misalignments in the thoracic or cervical spine. Repetitive motions and stressful postures, over time, may lead to the development of or aggravation of soft tissue damage or degenerative changes in the spinal column.
Tips for Controlling Upper Back Pain
The following may decrease cumulative trauma and may reduce the amount of your upper back pain:
Seek Medical Consultation
Seek medical consultation for upper back pain, especially in the following instances:
- After recent significant trauma, such as a fall, a motor vehicle accident or other such accidents.
- When sleep is disrupted or pain is worse at night.
- With a history of prolonged steroid use.
- With a history of osteoporosis.
- With a recent history of infection or a temperature over 100 degrees F.
- Numbness or tingling in arms.
- Severe, sudden headache.
How Is Back Pain Diagnosed
To diagnose the cause of your middle back pain, your doctor will ask about your medical history and symptoms. Theyll perform a physical exam. Your doctor may also perform a more specific neurological exam if youre experiencing numbness and weakness.
Your doctor may also recommend one or more of the following tests:
Ready To Address Your Back Pain
The University of Maryland Spine Network can help you put your pain behind you. With convenient locations throughout the state, the UM Spine Network is home to the region’s leading spine surgeons and specialists that can help you identify the source of your pain and put an end to it for good.
Put an end to your back pain. Find a spine specialist near you.
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What Causes Middle Back Pain
Thoracic spine pain is more often caused by serious underlying spinal pathology compared to the causes of lower back or neck pain. However, this symptom can also occur in healthy individuals with no apparent injury or illness. Surprisingly, children and adolescents, primarily females, are more prone to TSP. This could be due to a number of factors, including heavy backpack use, participation in certain sports, chair height at school or strain while doing homework.
More Advanced Care Options
Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:
Implanted nerve stimulators
- Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
- Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
- Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.
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When To Contact A Medical Professional
Contact your provider right away if you have:
- Back pain after a severe blow or fall
- Burning with urination or blood in your urine
- History of cancer
- Loss of control over urine or stool
- Pain traveling down your legs below the knee
- Pain that is worse when you lie down or pain that wakes you up at night
- Redness or swelling on the back or spine
- Severe pain that does not allow you to get comfortable
- Unexplained fever with back pain
- Weakness or numbness in your buttocks, thigh, leg, or pelvis
Also contact your provider if:
- You have been losing weight unintentionally
- You use steroids or intravenous drugs
- You have had back pain before, but this episode is different and feels worse
- This episode of back pain has lasted longer than 4 weeks
Treatment For Mild To Moderate Pain
In most cases, people with mild to moderate upper and middle back pain can manage their symptoms with:
- Over-the-counterpain medicines, such as acetaminophen and non-steroidal anti-inflammatory drugs , to reduce pain. But if these don’t get rid of your pain, you may need a prescription pain medicine that is stronger.
- Over-the-counter muscle relaxants, such as methocarbamol . These can relax muscles and may reduce pain.
- Heat or ice to reduce pain and stiffness.
- Exercise to stretch and strengthen the muscles of your back, shoulders, and stomach.
- Physiotherapy to help increase your flexibility, strength, and balance. Your physiotherapist may teach you an exercise program so you can do it at home.
- Massage to help reduce muscle tension and pain for a short time and to improve blood flow.
- Spinal manipulation to help relieve pain and improve function. It can range from massage and slow pressing to a quick thrust.
- Acupuncture. It involves putting tiny needles into your skin at certain points on the body to promote healing and pain relief.
- Capsaicin cream may help relieve pain.footnote 1 Capsaicin is a substance contained in cayenne peppers. Capsaicin cream is applied directly to the skin over the painful area. Do not apply topical products that contain capsaicin to areas of broken skin.
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What Can Cause Pain In Center Of Chest
Chest pain is a common and one of the most discussed experiences. Chest pain is a feeling of pain and discomfort in the area of thoracic cavity or chest, extending from the neck to the upper abdomen.
A slight pain in the chest area can send waves of fear running down your mind. You are sure to think what could have caused this chest pain? Pain in chest is often feared of and is attributed to a heart attack. While this is a possibility, there are a host of other causes of chest pain.
When you experience pain in the center of chest, you would like to consider various other reasons that could be bothering you in the form of chest pain. The pain in center of chest can be of dull and constant type or chest pain that may come and go. Sometimes pain in center of chest may occur on stretching, exercising, breathing deeply or lying down. A careful history and examination can guide towards the possible causes of chest pain in center of chest.
Why Is Lower Back Pain Such A Common Problem
The bottom part of your back typically has just five vertebrae fewer than your neck and mid-back. And these vertebrae do a lot of heavy lifting! Your lower back is where your spine connects to your pelvis, bearing the weight of your upper body. This area experiences a lot of movement and stress, which may lead to wear, tear and injuries.
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Why Back Pain Requires A Team Approach To Care
Whether back pain requires surgery or is manageable with conservative treatment, its important to see a spine specialist for diagnosis and care. The doctors at our Spine Center work as a team with experts in nerve, muscle, and bone conditions, as well as nurses and physical therapists who work closely with patients to manage symptoms and reduce the risk of recurrence.
Each week, our multidisciplinary team meets to discuss challenging cases and educate each other on the latest research and techniques. Together, we see a range of patients with complex medical needs. For example, if a patient with a spinal infection is taking a medication that suppresses the immune system, such as immunotherapy for cancer, we work together to find an effective treatment that is safe for their unique needs.
When To See A Doctor
If youâre like most people with upper and middle back pain, youâll be able to manage your symptoms at home. Over-the-counter pain relievers, heat, or ice may be enough to ease your condition.
You should call your doctor, though, if your pain becomes too intense or starts to keep you away from your daily activities.
Certain symptoms require fast attention. They include:
- Losing control of your bowels or bladder.
- Fever along with pain.
- Pain that starts after a fall, an accident, or a sports injury.
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Treatment Options For Acute Lower Back Pain
Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also have the ability to block pain. Opioids provide pain relief and may at times be prescribed to manage severe back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
Other nonsurgical treatments for lower back pain include Intradiscal electrothermal therapy , nucleoplasty, and radiofrequency lesioning.
A Compression Fracture Of L1 Causes Symptoms And Treatment
A compression fracture of L1 is a break in the vertebrae, which is the bone that makes up the spine. This type of fracture can be caused by a fall, a car accident, or any other type of trauma to the spine. Symptoms of a compression fracture of L1 include pain in the lower back or buttocks, numbness in the legs, and difficulty walking. Treatment for a compression fracture of L1 typically includes rest, ice, and pain medication. In some cases, surgery may be necessary to stabilize the spine.
Fractures in the lower back are a serious injury that occurs both when osteoporosis is present and when a trauma has been involved. When this happens, surgery is recommended neurological deficits are uncommon, but this condition can lead to neurological damage. The most common reason for lower back pain is compression fractures in the lower back.
immobilization in a brace or corset can be used for up to a year after a fracture. Bracing improves pain management as well as deformity prevention.
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Am I Likely To Get Back Pain
Several factors can increase your chances of having upper and middle back pain. Among them:
- Age.Back pain starts for most people in their 30s or 40s, and itâs more common the older you get.
- Being out of shape. The stronger the muscles in your back, shoulder, and abdomen, the lower your chance of injury.
- Weight. If you carry extra pounds, you put more strain on your back.
- Underlying conditions. Diseases such as arthritis and cancer can cause back pain.
- Smoking. Smokerâs cough can strain your back. And if you smoke, you may be slower to heal, which can make your back pain last longer.
Mechanical Lower Back Pain
Because it represents 97% of cases, mechanical low back pain deserves to be discussed first. To determine the factors that bring out the pain, the doctor will consider the following causes of mechanical low back pain:
- Spondylolisthesis .
- Osteoarthritis .
- Spinal stenosis .
Low back pain that gets worse with sitting may indicate a herniated lumbar disc . This is because certain positions of the body can change the amount of pressure that an out-of-place disc can press on a nerve. This is one reason we suggest to people with low back pain to periodically get up and stretch or walk around rather than continually stay sitting. Acute onset, that is, pain that comes on suddenly, may suggest a herniated disc or a muscle strain, as opposed to a more gradual onset of pain, which fits more with osteoarthritis, spinal stenosis, or spondylolisthesis.
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Who Gets Back Pain
Anyone can have back pain however, several factors increase your risk. Risk factors increase your chance of developing back pain and can include:
- Fitness level: Back pain is more common among people who are not physically fit. For example, weak back and stomach muscles may not properly support the spine. Back pain is also more likely if you exercise too strenuously after being inactive for a while.
- Weight gain: A diet high in calories and fat, combined with an inactive lifestyle, can lead to obesity. This can put stress on the back.
- Job-related risk factors: Jobs that require heavy lifting, pushing, pulling, or twisting can injure the back. A desk job may also play a role, especially if you have poor posture or sit all day in an uncomfortable chair.
- Age: Back pain becomes more common with age, particularly after the age of 45.
- Heredity: Genetics play a role in some disorders that cause back pain.
Muscle Strain And Ligament Sprain
A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements.
- Strains occur when a muscle is stretched too far and tears, damaging the muscle itself.
- Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together.
For practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same.
Common causes of sprain and strain include:
- Lifting a heavy object, or twisting the spine while lifting
- Sudden movements that place too much stress on the low back, such as a fall
- Poor posture over time
- Sports injuries, especially in sports that involve twisting or large forces of impact
While sprains and strains do not sound serious and do not typically cause long-lasting pain, the acute pain can be quite severe.
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What Is Upper Back Pain
Upper back pain occurs anywhere from the base of your neck to the bottom of your rib cage. Your upper and middle back is called the thoracic spine. Your thoracic spine has 12 small bones called vertebrae. Your vertebrae form your backbone.
Each of the vertebrae on your thoracic spine is connected to a pair of ribs. Your ribs wrap around your body to a long, flat bone down the center of your chest called the sternum. This forms your rib cage.
Your upper back also has disks that separate each vertebrae. These disks absorb shock as you move. There are also many muscles and ligaments in your upper back that hold your spine together. Upper back pain may be caused by many different medical issues or injuries to the bones, disks, muscles and ligaments in your upper back.
Upper back pain is not as common as neck pain or low back pain. This is because the bones in the upper area of your back don’t move or flex as much as the bones in your neck and lower back. The bones in your upper back work with the ribs to keep the back stable. They work together to help protect vital organs in your body including your heart and lungs.
The Risks Of Running For Those With Back Pain
A person must be aware of the risks associated with running, regardless of the benefits that it may provide. Running can cause pain in the back because the discs on the back of the spine thin out. Furthermore, running can aggravate existing back pain conditions and cause imbalances in the muscles. As a result, if you have back pain, you should refrain from running entirely.
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Lower Back Pain Caused By Infection
Infections of the spine are not common, but they do occur. The doctor will ask about the usual signs and symptoms of infection, especially when back pain is accompanied by fever and/or chills. Dialysis patients, IV drug users, and patients who have recently had surgery, trauma, or skin infections are at risk for infections of the spine. Infections of the spine can be caused by a number of agents, most commonly bacteria. Doctors will first test for the presence of bacteria, then give antibiotics.
Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
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