Upper Right Back Pain: Causes and Solutions - Orthopedics

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Upper right back pain can be a complex issue, especially when it has persisted for nearly a year and is associated with specific activities like deep breathing, lying down, or stretching. Given your history of playing sports such as basketball and volleyball, as well as your experience with ankylosing spondylitis (AS), it is essential to consider various potential causes and solutions.


Possible Causes of Upper Right Back Pain
1. Muscle Strain or Sprain: Engaging in sports and heavy lifting can lead to muscle strains, particularly if proper techniques are not used. The pain you feel during deep breathing or stretching could indicate that the muscles in your upper back are strained or overworked.

2. Nerve Compression or Irritation: Conditions such as a herniated disc or spinal stenosis can lead to nerve compression, which may cause localized pain or referred pain in the upper back. Given your history of ankylosing spondylitis, which can affect spinal alignment and mobility, nerve-related issues should be considered.

3. Postural Issues: Poor posture, especially during sports or while sitting for extended periods, can lead to muscle imbalances and pain. If you tend to slouch or have a forward head posture, this could contribute to your discomfort.

4. Referred Pain: Sometimes, pain in the upper back can be referred from other areas, such as the neck or even internal organs. Although you have had a chest X-ray that showed no issues, it is still important to rule out any potential referred pain from other conditions.

5. Ankylosing Spondylitis: Since you have a history of AS, it is crucial to consider that your condition may be contributing to your upper back pain. AS can lead to inflammation of the spine and surrounding tissues, which may manifest as pain in various areas, including the upper back.


Recommended Solutions
1. Physical Therapy: Consulting a physical therapist can be beneficial. They can provide a tailored exercise program that focuses on strengthening the muscles of the back, improving flexibility, and correcting posture. Techniques such as manual therapy may also help alleviate pain.

2. Pain Management: Over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen, can help manage pain and reduce inflammation. However, it is essential to consult with a healthcare provider before starting any medication, especially considering your medical history.

3. Posture Correction: Focus on maintaining good posture during daily activities and sports. Ergonomic adjustments to your workspace or using supportive seating can also help alleviate strain on your back.

4. Stretching and Strengthening Exercises: Incorporate regular stretching and strengthening exercises into your routine. Focus on exercises that target the upper back, shoulders, and core muscles. Yoga or Pilates can also be beneficial for improving flexibility and strength.

5. Regular Check-ups: Given your history of ankylosing spondylitis, regular follow-ups with a rheumatologist or orthopedic specialist are essential. They can monitor your condition and adjust treatment plans as necessary.

6. Heat and Cold Therapy: Applying heat or cold packs to the affected area can provide temporary relief. Heat can help relax tight muscles, while cold therapy can reduce inflammation.


Conclusion
In summary, upper right back pain can stem from various causes, including muscle strain, nerve issues, postural problems, and underlying conditions like ankylosing spondylitis. It is crucial to seek a comprehensive evaluation from a healthcare professional to determine the exact cause of your pain and develop an appropriate treatment plan. Engaging in physical therapy, practicing good posture, and incorporating regular exercise can significantly improve your symptoms and overall quality of life. If your pain persists or worsens, further diagnostic imaging or specialist consultations may be necessary to rule out more serious conditions.