Back pain in the upper back
introduction
Upper back pain is less common than Lower back pain. If here Back pain present, these are very often combined with pain in the neck. The Musculature in the upper back has the task of keeping the upper body upright despite the force of gravity and is therefore exposed to strong constant stress.
Causes of Upper Back Pain
The most common cause of upper back pain is poor posture, especially the so-called “stop reflex posture”.
In the long term, the upper back and neck area are pulled more towards the front, creating a picture similar to that of a hump.
This creates permanent tension and inadequate tension on the muscles of the upper back and neck, which sooner or later start to become very painful.
This posture is also often used in special situations, especially when it is very cold, which is why this type of pain is more common in the cold season. But other conditions, such as trauma to the front of the body, sudden loud noises or negative ideas can cause this stop pattern, which generally serves as a protective reaction of the body: the head is protected by the hunched shoulders and the hunched posture and the environment is kept as small as possible required for "attacks" of all kinds.
Another cause of back pain in the upper back and shoulder area can be trauma. These do not necessarily have to precede the back pain, but can also go back many years before the back pain occurs. An example of this is whiplash or falling on this section of the back, for example from a swing.
The treatment of this pain primarily requires a correction of the incorrect posture, otherwise it can never go away completely and the person concerned plagues again and again. There are also special back exercises that loosen the posture and enable an upright posture. The corresponding muscles should be strengthened, which can be achieved, for example, with the help of a Thera-band or fitness equipment on which one pulls from top to bottom.
Some massage, yoga, or connective tissue treatment can also relieve back pain. In general, physiotherapy should only be carried out under the professional guidance of a doctor or physiotherapist in order to achieve a good result.
Read more on the topic: Symptoms of a heart attack
Blockage of the cervical spine as a possible cause
Blockages of various vertebrae the spine are relatively common. Here it comes from a careless movement in the area of the back to a lifting of one vertebra of the cervical spine and an oblique reconnection to the vertebra below. The blockage of these two vertebral bodies is a mechanical problem, and in part of violent pain accompanied. Often there are also neurological complaints, such as tingle or Numbness which then usually radiate into the arms.
Treatment with tablets or injections is usually unsuccessful because the pain occurs on one mechanical blocking are based. With every movement that cannot be fully performed for this reason, there is also another accompanying muscle tension laterally in the area of the spine, which in turn leads to increased pain.
Osteopathic treatment is a possible measure that can often help relieve a cervical blockage. To do this, the osteopath approaches the patient from behind, places the flat of his hand on the patient's right and left ears and pulls the patient's head up a little before bringing it back into the correct position.
When the head is pulled up, the blockage usually releases on its own. In the case of recurring cervical spine blockages that lead to back pain, one should always be physiotherapy treatment be carried out for prevention. In any case, it is important to train the muscles in the area of the spine, especially in the area of the cervical spine. Corresponding exercises are carried out by the physiotherapist and given to the patient for their own use.
Appointment with a back specialist?
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.
The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
Localization of the pain in the upper back
Left-sided upper back pain
Back pain is one of the most common complaints that patients see to the doctor these days. Almost everyone over the age of 20 has had severe or weaker back pain at some point in their life. Most causes of upper back pain are harmless. However, it is very important to consider and treat dangerous courses of back pain and their causes.
Read more on the topic: Symptoms of a heart attack
Pain that starts selectively on the left in the upper back area usually has nothing to do with the intervertebral disc. On the side of the spine are strong muscles that are responsible for the stability of the spine and movement. The most common cause of back pain in the upper left side of the back is muscular tension or strains. One also speaks of a myogelosis.
The pain can occur when moving or at rest; it can continue from the left side through the middle to the right side. Muscular tension usually does not cause neurological deficits, such as a radiance in the arms or legs. Such neurological abnormalities would then correspond to a possible herniated disc, which, however, usually leaves a centrally directed pain.
In the differential diagnosis, however, kidney problems should always be considered and excluded in the area of the left upper back. Kidney stones but also so-called renal pelvic inflammation can lead to left-sided, stabbing or pressing pain in the upper back. The examiner taps the painful area, makes the patient do appropriate flexing exercises (Trunk and side bends) to see how flexible the spine is. If there is any doubt as to whether the problem is a spinal column or a kidney problem, an ultrasound examination of the back should be carried out on the one hand, and a urine test on the other, which would provide information about abnormalities in the kidney excretion.
Right-sided upper back pain
Right back pain in the upper section is just as common as the left-facing complaints. Also here are mostly muscular indurations to blame for the fact that the person concerned reports moderate to severe pain in the area of the right side when resting but also when moving.
When examining the patient, it should first be checked to what extent his spine movable is and where it is restrictions gives. For this purpose, the orthopedic surgeon will have the patient perform movements in the spine area, mainly from a Forward flexion, from a Backward flexion and from one Side flexion consist.
The examiner will also pat the patient's right back to find out whether this area is particularly painful and sensitive.If this is the case, a Kidney disease that lie at this level on both the left and right of the spine.
Exist in addition to back pain fever, nausea and Vomit, so should also be sent to a Pelvic inflammation be thought. Severe weakness accompanying the back pain also indicates kidney involvement. To safely rule out kidney involvement, a Ultrasound scan of the kidneys and a Urinalysis be performed.
Central pain in the upper back
Also very often described are back pain of the upper back, which is mainly localized in the middle. It is very important to find out since when the discomfort is present whether the pain radiate, if so, where, and whether the complaints at rest or when moving occur. Finally, it should also be found out whether it is neurological abnormalities there, i.e. whether the patient reports pain radiation in the arms or legs. This could also apply to one disc prolapse suggest, which one can then use an imaging procedure (MRI or CT) would have to diagnose.
Even if the patient states that he has one in arms or legs Numbness or tingle senses a herniated disc should be considered.
The middle part of the upper back can also be affected by muscle tension and lead to severe discomfort in this area. Sometimes inflammation can also occur in the vertebral body. One also speaks of one Spondylodiscitisthat is not harmless and needs urgent treatment. If left untreated, vertebral inflammation can spread and lead to further serious courses.
A X-ray in this context provides decisive information as to whether there is an inflammation of the vertebral bodies. If it is such an inflammation, one must immediately anti-inflammatory and antibiotic treatment which sometimes even has to take place in an inpatient setting.
Figure back pain
A - neck pain
B - upper back pain
C - lumbar spine pain
Lumbago (lumbago)
D - lumboglutealgia
(Radiating into the buttocks)
E - Lumboischialgia
(Radiating into the leg)
- First cervical vertebra (carrier) -
Atlas - Seventh cervical vertebra -
Vertebra prominent - Trapezius -
Trapezius muscle - Broad back muscle -
Muscle latissimus dorsi - First lumbar vertebra -
Vertebra lumbalis I - Fifth lumbar vertebra -
Vertebra lumbalis V - Sacrum - Sacrum
- Tailbone - Os soccygis
- Iliac crest -
Iliac crest - Gluteus Middle -
Muscle gluteus medius - Gluteus Muscle -
Muscle gluteus maximus - Big Dresser -
Adductor magnus muscle - Two-headed hamstrings -
Biceps femoris muscle
a - Disc prolapse -
Nucleus pulposus prolapse (from above)
b - vertebral fracture
(Vertebral fracture)
c - spinal osteoarthritis -
(Joint wear)
You can find an overview of all Dr-Gumpert images at: medical illustrations
Concomitant symptoms and diseases
Upper back pain and lung cancer
The dangerous one Lung cancer is above all that the disease usually goes unnoticed for a very long time. The main reason for this is the Freedom from symptomsbefore lung cancer causes discomfort. Back pain too -if any- first one very late symptom of lung cancer. Back pain caused by a carcinoma in the lungs usually only occurs when either the tumor has spread so far that it has spread Pressure on a nerve tract near the back, or when the tumor spreads with Metastases and has settled and these appear in the vertebral bodies.
Here it can always lead to a very difficult course pathological fracture of the vertebral bodies come. When a bronchial carcinoma is diagnosed, the entire skeleton is always scanned to see whether there are already metastases at any point. These would then mostly be in the area of back pain Ribs or the Vertebral bodies stand out.
Upper back pain and cough
After a bronchitis or Pneumonia Severe coughing attacks can always lead to severe back pain. The reason is that with every cough, the auxiliary respiratory muscles between the ribs are massively compressed and stretched so that the coughing stimulus can be implemented accordingly. The cough can become so strong and hard that it becomes one Rupture of the ribs can come. Such a fracture would also radiate painfully to the upper back.
The muscles between the ribs are supplied with nerves that can also pull into the back area. A hard cough and irritation of the muscles and nerves can also cause a Transmission of pain come in the back.
Back pain after coughing usually disappears very quickly. If not, one should close examination of the back respectively. Symptomatically, this type of pain can be treated with anti-inflammatory pain relievers such as ibuprofen or diclofenac.
Upper back pain and difficulty breathing
If breathing problems occur in connection with back pain, attention should always be paid to the strength and onset of the symptoms. So it can be a posture problem in the spine area, which leads to a constriction to a shortness of breath (with a hunched back, the lungs do not have that much space to expand and breathe in enough air), it can also be a dangerous pulmonary embolism if a blood clot has formed in the lungs.
Especially after long journeys or a previous leg vein thrombosis, the combination of severe shortness of breath and pain in the back as well as pain when inhaling can occur. However, back pain is usually absent from the complete picture of a pulmonary embolism.
Furthermore, an aortic aneurysm should also be excluded in the event of sudden shortness of breath with severe back pain. However, this clinical picture is still associated with severe pain in the chest.
Read more about this on our website Pain in the back when breathing.
What to do if you have upper back pain
In addition to muscle-building exercises, it is also very important to observe certain everyday behaviors during the day. So should possible back-friendly shoes be worn, so no high-heeled. It should also be used when working on the desk regular breaks be respected. It is not necessary to leave the workplace here. Every 20 minutes you should change your sitting position and bend briefly forwards and backwards as well as to the side. If you don't want to do this, you can also lie back for a moment, tense the muscles of the back very firmly and then relax.
Such exercises should be integrated into the work several times a day. Furthermore, you should pay particular attention to the Type of sitting be respected. Knee chairs is said to be particularly back-friendly. You can also use these chairs instead Exercise balls be taken.
After work should be a balancing sport be performed. swim or To go biking offer themselves, whereby attention should be paid to a suitable handlebar-saddle distance when cycling.
Ultimately, it should be found out at least once orthopedically whether a Misalignment of the spine is available. If necessary, an orthopedic shoe insert can prevent recurring back pain.
Exercises for upper back pain
Most back problems occur at regular intervals and the patient is familiar with the course. As a rule muscular problems Behind the back pain, there are numerous exercises that both as preventive as well as treating measure can be used. If muscular problems are to blame for the recurring pain in the spine, this is mostly because the muscles in the spine are either too weak are, i.e. they fail to keep the spine upright and in motion to the extent and stability, or the muscles cramp and there are indurations on the side of the spine.
Cramping can also be the result of muscle weakness. In order to strengthen but also loosen the muscles at the same time, it is particularly important to do the exercises very regularly and on the other hand, warm up the muscles before starting the exercises.
One possible back exercise to train the back muscles is that walking on your toes. Here you stretch as far as you can and try to reach the ceiling with your fingertips. This walk can be bouncy and should be done for a few minutes.
Than are Flexing and stretching exercises both to the front (Fingertips on the ground) and backwards (Bridge exercise) very important to train the back muscles. Also on the side Trunks (the left hand moves down the left leg) will train the muscles in the spine area.
Another exercise is having a great Exercise ball feasible. Here the patient lies down with his back on it, his legs are firmly on the floor and his arms are crossed. By trying the balance Keeping on the moving ball, the corresponding back muscles are inevitably trained.
Upper back pain during pregnancy
Back pain during pregnancy is very common. The main reason is that as the child grows, it also becomes one Weight redistribution of the woman's body comes. In order to be able to cope with the increasing child's weight, the pregnant woman initially takes it completely unfamiliar attitudes when sitting and walking. Since the muscles often cannot adjust to such new postures so quickly, it can become very fast Cramping or to Hardened muscles come in the spine area, which is then perceived as pain.
Lighter back pain in pregnant women can be with Heat pads or Massages be treated well. Some pregnant women also put a supportive, slightly adapted corset around the stomach.
Basically, pregnant women can do the same Back muscle exercises perform as non-pregnant women. It must be noted, however, that these exercises tend to have a long-term effect, i.e. one must regularly over many weeks do the back exercises before the muscles are toned.
However, the pregnancy-related back pain disappears after the baby is born. If there is pain in the spine that cannot be controlled, it can also be used for pregnancy Pain medication are used. It should be mentioned here primarily Paracetamol. Here a reduced dose can e.g. 250 mg twice a day for 3 days relieve the pain if other measures do not help. The intake of ibuprofen or diclofenac should be avoided because of the child.
Further information can be found on our website Medication in Pregnancy.
Very severe back pain during pregnancy that does not respond to pain reliever medication and cannot be relieved should also be examined by an orthopedic surgeon. In some cases it can be a pregnancy disc prolapse which should then also be treated. Whether such an operation should take place before or after the birth of the child depends on the severity of the incident.
Lately they have been used to treat back pain as a whole but also to treat back pain in pregnant women as well Acupuncture techniques enforced, which can alleviate or even completely eliminate the pain in the back area.
