Upper Back Pain: Causes and Connections to MRI Findings - Neurology

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Understanding upper back pain can be complex, especially when considering the connections to MRI findings. Your symptoms, including upper back pain localized to the right side, shoulder pain, and discomfort when turning your head, are indeed concerning and warrant a thorough evaluation.

Based on your MRI report from September, it indicates a posterior bulging disc at the C6/7 level, which is causing mild indentation on the thecal sac and narrowing of the bilateral neural foramina. This finding suggests that there is some degree of nerve root compression, which can lead to pain, numbness, or weakness in the areas supplied by the affected nerves. In your case, the C6 and C7 nerve roots are likely involved, which can contribute to pain radiating into the shoulder and upper back.

The relationship between your current symptoms and the MRI findings is significant. The bulging disc may be causing irritation or compression of the nerves that innervate the muscles in your upper back and shoulders. This can lead to muscle tension and pain, particularly if you are maintaining poor posture or sitting for extended periods, as you mentioned. The fact that your pain sometimes wakes you at night and improves with movement suggests that it may be related to nerve irritation or muscle spasms.

There are several potential causes for your symptoms:
1. Cervical Radiculopathy: The bulging disc at C6/7 can lead to cervical radiculopathy, where the nerve roots are compressed, causing pain that can radiate to the shoulder and upper back. This is consistent with your description of pain when turning your head.

2. Muscle Strain or Tension: Prolonged sitting and poor posture can lead to muscle strain, particularly in the trapezius and rhomboid muscles, which can cause upper back pain. This is often exacerbated by stress and tension.

3. Referred Pain: Sometimes, pain in the upper back can be referred from other areas, such as the cervical spine or even the thoracic spine. The interconnected nature of the spine means that issues in one area can manifest as pain in another.

4. Degenerative Changes: As we age, the discs and joints in the spine can undergo degenerative changes, leading to bulging discs, arthritis, and other conditions that can contribute to pain.

To address your symptoms, consider the following recommendations:
- Posture Correction: Ensure that your workstation is ergonomically set up to promote good posture. Take breaks every 15-30 minutes to stretch and change positions.

- Physical Therapy: A physical therapist can provide targeted exercises to strengthen the muscles supporting your spine and improve flexibility, which may alleviate some of your pain.

- Heat Therapy: Applying heat to the affected area can help relax tense muscles and improve blood flow, providing relief from pain.

- Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and alleviate pain, but consult your physician before starting any medication.

- Follow-Up MRI: If your symptoms persist or worsen, a follow-up MRI may be warranted to assess any changes in your condition, especially if there are concerns about the progression of the bulging disc or other spinal issues.

In conclusion, your upper back pain is likely connected to the MRI findings of the bulging disc at C6/7, which may be causing nerve root irritation. Addressing your symptoms through posture correction, physical therapy, and possibly medication can help manage your pain. If symptoms persist, further evaluation by a specialist may be necessary to explore additional treatment options. Always consult with your healthcare provider for personalized advice and treatment plans.