Lower back pain is a common problem among people suffering from chronic pain, and while 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.
While there can sometimes be an injury to a disc in the upper back (such as a thoracic herniated disc or degenerated disc) that causes severe upper back pain, such injuries are usually very rare.
The reason why upper back pain is so rare is that the thoracic spine (also called upper back, middle back, or mid-back) is very different in form and function than the cervical spine (neck) or the lumbar spine (lower back). The neck and lower back are designed to provide us with mobility, but the thoracic spine is designed to be very strong and stable to allow us to stand upright and protect the vital internal organs in the chest. Because this section of the spinal column has a great deal of stability and only limited movement, there is generally little risk of injury or degeneration over time in the upper back.
Because there is little motion and a great deal of stability throughout the upper back (thoracic spine), this section of the spine does not tend to develop common spinal disorders, such as a herniated disc, spinal stenosis, degenerative disc disease, or spinal instability. These conditions can cause upper back pain but are exceedingly rare in the upper back.
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Because of this stability and lack of motion, in most cases, anatomic causes of upper back pain cannot be found, and an MRI scan or CT scan will rarely image an anatomic problem that is amenable to any sort of surgical solution for the upper 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: muscular irritation (myofascial pain) and joint dysfunction.
The shoulder girdle attaches by large muscles to the scapula (the shoulder blade) and the back of the thoracic rib cage. These large upper back muscles are prone to developing irritation (myofascial pain) that can be painful and difficult to work out.
Often, muscular irritation and upper back pain are 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.
The ribs connect with the vertebrae in the thoracic spine by two joints that connect with each side of the spine, and dysfunction in these joints can result in upper back pain.
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