Upper Back Pain: Causes, Symptoms, and Treatment Options

Upper back pain issues?

Hello, Doctor.
I have been experiencing upper back pain for almost two weeks.
I have applied topical analgesics and taken muscle relaxants, but there has been no improvement.
I wonder if this is related to the fact that I was bedridden for an extended period due to a cold the previous week.
The pain sometimes occurs at the points where the shoulder blades are indented on both sides, and at times in the middle of the shoulder blades.
In the morning, I often feel a dull pain, and there is also a slight tightness in my chest, but these pains are brief and occur at unpredictable times—sometimes while driving, sometimes while eating, and occasionally the pain is severe enough to make me feel nauseous.
I cannot stand for long periods.
In addition to the upper back pain, I sometimes experience pain in the middle of my chest and on both sides near the armpits.
I have a history of gastroesophageal reflux disease, for which I am taking medication, and I also have been experiencing chronic chest tightness for which I am taking antiarrhythmic medication.
Currently, there are no issues with my heart.
What do you recommend, Doctor? Thank you.

Enola, 20~29 year old female. Ask Date: 2023/01/27

Dr. Wang Zhaomin reply Rehabilitation

This is a consultation platform and cannot provide a diagnosis.
Neuromuscular tissue lesions in the shoulder and neck area can potentially cause related symptoms.
It is advisable to try applying heat to the affected area and to enhance stretching exercises.
If symptoms persist or worsen, it is important to seek medical attention from an orthopedic specialist, neurologist, or rehabilitation physician as soon as possible for an accurate diagnosis and appropriate treatment.

Reply Date: 2023/01/27

More Info

Upper back pain can be a complex issue, often resulting from a combination of factors including muscle strain, poor posture, and underlying medical conditions. Based on your description, it seems that your upper back pain has persisted for nearly two weeks, and despite using topical analgesics and muscle relaxants, you have not experienced significant relief. Additionally, you mentioned a recent illness that required prolonged bed rest, which could contribute to muscle stiffness and discomfort.

Causes of Upper Back Pain
1. Muscle Strain: Prolonged periods of inactivity, such as lying in bed due to illness, can lead to muscle stiffness and strain. This is particularly true if you were not maintaining good posture while resting.

2. Poor Posture: Activities such as driving or sitting for extended periods can exacerbate upper back pain, especially if your posture is not optimal. Slouching or leaning forward can place additional stress on the muscles and ligaments in your back.

3. Referred Pain: Given your history of gastroesophageal reflux disease (GERD) and the chest discomfort you experience, it’s possible that some of your upper back pain could be referred pain from your gastrointestinal issues. The esophagus and the upper back share nerve pathways, which can sometimes lead to confusion in pain perception.

4. Nerve Compression: Conditions such as herniated discs or spinal stenosis can lead to nerve compression, resulting in pain that radiates to the upper back and shoulders.

5. Anxiety and Stress: Emotional stress can lead to muscle tension, particularly in the upper back and shoulders, contributing to discomfort.

Symptoms to Monitor
- Pain Location: You mentioned pain around the shoulder blades and the middle of your back. Pay attention to whether the pain is localized or if it radiates to other areas, such as the arms or chest.

- Pain Characteristics: Note if the pain is sharp, dull, or throbbing, and whether it worsens with certain activities or positions.

- Associated Symptoms: Symptoms such as nausea or vomiting, especially if they occur with pain, should be evaluated further to rule out any serious underlying conditions.

Treatment Options
1. Physical Therapy: Engaging in physical therapy can help strengthen the muscles in your back and improve your posture. A physical therapist can provide tailored exercises to alleviate pain and prevent future issues.

2. Posture Correction: Focus on maintaining good posture during daily activities. Ergonomic adjustments to your workspace, such as using a chair that supports your back and keeping your computer screen at eye level, can be beneficial.

3. Pain Management: While topical analgesics and muscle relaxants are helpful, consider discussing other pain management options with your healthcare provider. Nonsteroidal anti-inflammatory drugs (NSAIDs) may provide additional relief.

4. Stress Management: Techniques such as mindfulness, yoga, or meditation can help reduce muscle tension related to stress and anxiety.

5. Medical Evaluation: Since you have a history of GERD and are experiencing chest discomfort, it may be prudent to consult with a healthcare provider to rule out any cardiac or gastrointestinal issues that could be contributing to your symptoms.

6. Lifestyle Modifications: Incorporate regular physical activity into your routine, focusing on exercises that strengthen the back and core muscles. Additionally, ensure you are getting adequate rest and managing stress effectively.

Conclusion
Given the complexity of your symptoms and their persistence, it is essential to seek a comprehensive evaluation from a healthcare professional. They may recommend imaging studies, such as X-rays or MRIs, to assess for any structural issues in the spine. By addressing both the physical and potential emotional components of your pain, you can work towards a more effective treatment plan and improved quality of life. Remember, early intervention can often lead to better outcomes, so don’t hesitate to reach out for further medical advice.

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