Thoracic Upper Back Pain

Although upper back pain is not a very common spinal disorder, it can cause significant discomfort and pain when it does occur. The most common causes of upper back pain are muscular irritation (myofascial pain) and joint dysfunction.

There can be an injury to a disc in the upper back (such as a herniated discor degenerated disc) that causes upper back pain as well.




What are the causes of upper/mid-back pain?

Upper Back Pain can occur as a result of trauma or sudden injury, or it can occur through strain or poor posture over time. As an example of the latter cause, in recent years, upper back pain has become a familiar complaint from people who work at computers most of the day. Often, upper back pain occurs along with neck pain and/or shoulder pain.

The vast majority of cases of upper back pain are due to one (or both) of the following causes:

  • Muscular irritation (myofascial pain)
  • Joint dysfunction
  • Herniated disc, or degenerated disc



Myofascial Pain

Often muscular irritation and upper back pain is due to either de-conditioning (lack of strength) or overuse injuries (such as repetitive motions). Muscle strains, sports injuries, auto accidents, or other injuries can all result in pain from muscular irritation.




Joint dysfunction causing upper back pain

The ribs connect with the vertebrae in the thoracic spine by two joints that connect with each side of the spine. Dysfunction in these joints can result in upper back pain. In addition arthritic changes may occur in the joints of the spine that may also lead to pain.




Other causes of thoracic back pain

Because there is little motion and a great deal of stability throughout the thoracic spine, it does not tend to develop disc herniations, spinal stenosis, degenerative disc disease, or instability (e.g. spondylolisthesis). As an example, only about 1% of all disc herniations occur in the thoracic spine. The vast majority of disc herniations occur in the lumbar spine, where there is a lot of motion.

Rarely, upper back pain can be caused by thoracic disc disease—such as a degenerated disc or herniated disc, however in some patients significant pain can occur due to these conditions. A correct diagnosis of thoracic disc disease or injury requires diagnostic tests (such as an MRI scan) and correlation with physical symptoms.

Additionally, significant impact or trauma to the spine can result in a fracture of the thoracic vertebrae. If this happens, a physician needs to be consulted immediately and diagnostic tests (such as an X-ray or MRI scan) are required to determine the extent of the damage and develop a treatment plan.


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