Upper Right Back Pain: When to Seek Medical Attention - Family Medicine

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Upper right back pain can be a concerning symptom, especially when it is severe enough to disrupt your daily activities and sleep. Based on your description, it sounds like you are experiencing significant discomfort that is not typical of a simple muscle strain. Here’s a comprehensive look at your situation and guidance on what steps to take next.


Understanding Your Symptoms
1. Nature of Pain: The fact that your pain is described as sharp and comes in waves, along with the sensation of numbness in your hand, suggests that it may not be purely muscular. Conditions affecting the spine, nerves, or even internal organs could be contributing to your symptoms.

2. Possible Causes:
- Musculoskeletal Issues: While you mentioned that it doesn’t feel like a muscle strain, conditions such as a herniated disc or nerve impingement can cause similar symptoms. These can lead to referred pain in the upper back and even cause numbness or tingling in the arms.

- Nerve Compression: If a nerve in your cervical spine is compressed, it could lead to pain radiating into your upper back and arms, along with numbness.

- Visceral Pain: Given your history of heart-related symptoms, it’s important to consider that pain in the upper back can sometimes be referred from the heart or other internal organs. This is particularly relevant if you have experienced chest pain or discomfort previously.


When to Seek Medical Attention
1. Persistent or Worsening Symptoms: If your pain continues to be severe, especially if it worsens or does not improve with medication, it is crucial to seek further medical evaluation.

2. Neurological Symptoms: The presence of numbness or tingling in your hands, especially if it is new or worsening, warrants immediate attention. This could indicate nerve involvement that may require prompt treatment.

3. Cardiac Concerns: Given your previous heart symptoms, if you experience any chest pain, shortness of breath, or other signs of a heart issue (like sweating or nausea), you should seek emergency medical care immediately.


Recommendations
1. Continue Medication: If the muscle relaxants prescribed by your doctor provide some relief, it may be beneficial to continue taking them as directed. However, if you find they are not helping, or if you experience side effects, consult your doctor.

2. Specialist Consultation: If you decide to visit a hospital, you should consider seeing a specialist in either orthopedics or neurology. An orthopedic doctor can evaluate musculoskeletal issues, while a neurologist can assess nerve-related problems.

3. Diagnostic Imaging: Depending on the findings during your examination, your doctor may recommend imaging studies such as X-rays or MRI to assess the spine and surrounding structures for any abnormalities.

4. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any activities that seem to trigger or alleviate the pain. This information can be invaluable for your healthcare provider.


Conclusion
In summary, while muscle strain is a common cause of back pain, your symptoms suggest that a more thorough evaluation is necessary. Given the potential for serious underlying conditions, including those related to the heart, it is important to err on the side of caution. If your symptoms persist or worsen, do not hesitate to seek medical attention promptly. Your health and well-being are paramount, and timely intervention can make a significant difference in your recovery.