Upper Back Numbness and Burning Sensation: Possible Causes and Next Steps

Numbness, tingling, and a burning sensation in the back?

Hello, Doctor.
Since the end of June, I have been experiencing a tingling sensation in my upper left back (around the area of the "Gao Huang" point), similar to a mild electric current.
Gradually, by the evening, I started to feel a burning sensation.
In mid-July, I consulted a neurologist who indicated that there are no major nerve bundles in that area, so it is unlikely to be a nerve compression issue.
However, they drew five vials of blood to check for deficiencies in B12 and other minerals, as well as to conduct a thyroid test.
During my follow-up appointment the following week, the doctor reported that all blood tests were normal.
Subsequently, I underwent an X-ray to confirm that there was no cervical compression, but the cause of my symptoms remained elusive.
The doctor prescribed medication (pain relievers and muscle relaxants) for two weeks, but after completing the course, my symptoms did not improve; in fact, the burning sensation became more frequent and was accompanied by a stabbing pain.
The neurologist mentioned that if it were merely a minor nerve injury, it might self-repair within two weeks with medication.
If not, we could consider conducting a nerve conduction study, but since it is time-consuming and may not yield significant results for small nerve injuries, they initially opted not to proceed with that.
It seems the doctor believes that such a test might not be very helpful.
I would like to ask the doctor what other possible causes there might be and what further steps I can take.

Cherry, 40~49 year old female. Ask Date: 2021/08/13

Dr. Jiang Junyi reply Neurology

Dear Ms.
Cherry,
Your symptoms may suggest cervical radiculopathy.
Prolonged periods of looking down can lead to overuse of the trapezius muscles in the neck, resulting in neck and shoulder pain.
Initially, resting may alleviate the pain, but over time it can worsen and affect your daily activities.
If poor posture is maintained for too long, it may cause nerve root compression.

To diagnose this condition, electromyography (EMG) is necessary, which is commonly used for diagnosing spinal cord injuries.
I recommend focusing on rehabilitation and physical therapy.
Change your posture every 15 minutes to allow the neck tissues to rest; maintaining any posture (including a normal one) for an extended period can lead to tissue fatigue and inflammation.
Therefore, moving around briefly can reduce the risk of muscle inflammation.
Thank you for your inquiry.
If you have any related questions, feel free to discuss further!
Wishing you good health and happiness,
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2021/08/13

More Info

Upper back numbness and burning sensations can be concerning symptoms, and it’s understandable that you are seeking clarity on their potential causes and next steps. Based on your description, it seems that you have already undergone several evaluations, including blood tests and X-rays, which have not revealed any significant abnormalities. Here, I will discuss some possible causes for your symptoms, as well as recommendations for further evaluation and management.

Possible Causes
1. Nerve Compression or Injury: While your doctor indicated that there is no major nerve compression, it is still possible that there is a minor nerve injury or irritation that is not easily detectable through standard imaging. Conditions such as thoracic outlet syndrome or cervical radiculopathy could potentially lead to symptoms in the upper back, even if they are not evident on X-rays.

2. Muscle Strain or Spasm: Muscle strain or spasms in the upper back can lead to sensations of numbness or burning. This could be due to poor posture, repetitive strain from activities, or even stress. Muscle tension can irritate nearby nerves, leading to the symptoms you are experiencing.

3. Peripheral Neuropathy: Although your blood tests were normal, conditions such as diabetes or vitamin deficiencies (like B12 deficiency) can lead to peripheral neuropathy. It might be worth discussing with your doctor the possibility of further testing for conditions that can cause neuropathy, even if initial tests were normal.

4. Fibromyalgia or Chronic Pain Syndromes: Conditions like fibromyalgia can cause widespread pain and sensory disturbances, including numbness and burning sensations. If your symptoms are accompanied by fatigue, sleep disturbances, or other systemic symptoms, this could be a consideration.

5. Psychosomatic Factors: Stress and anxiety can manifest physically, leading to symptoms such as burning sensations and numbness. If you are experiencing significant stress, it might be beneficial to explore stress management techniques.

Next Steps
1. Follow-Up with Neurology: Since your symptoms have persisted despite initial treatment, it may be worthwhile to follow up with your neurologist. Discuss the possibility of nerve conduction studies or electromyography (EMG) to assess for subtle nerve damage or dysfunction.

2. Physical Therapy: Engaging in physical therapy can help address muscle imbalances, improve posture, and reduce muscle tension. A physical therapist can provide targeted exercises and modalities to alleviate your symptoms.

3. Pain Management: If you haven’t already, consider consulting a pain management specialist. They can offer additional treatment options, including medications, injections, or alternative therapies that may help alleviate your symptoms.

4. Lifestyle Modifications: Evaluate your daily activities and posture. Ergonomic adjustments at your workstation, regular breaks, and stretching exercises can help reduce strain on your upper back.

5. Stress Management: If you suspect that stress may be contributing to your symptoms, consider exploring stress reduction techniques such as mindfulness, yoga, or counseling.

6. Re-evaluation of Blood Tests: If symptoms persist, you might want to discuss with your doctor the possibility of re-evaluating your blood tests, particularly for vitamin levels or other metabolic conditions that could contribute to neuropathy.

Conclusion
In summary, while your initial evaluations have not identified a clear cause for your upper back numbness and burning sensations, there are several potential avenues to explore. It is important to maintain open communication with your healthcare providers and advocate for further evaluations if your symptoms persist. By taking a comprehensive approach that includes medical evaluation, physical therapy, and lifestyle modifications, you can work towards finding relief and improving your overall quality of life.

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