Upper Back Pain: Causes and Treatment Options - Rehabilitation

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Upper back pain, particularly in the area near the shoulder blade, can be quite distressing and may stem from various underlying causes. Your description of sharp, stabbing pain that worsens with touch and during activities like typing suggests a few potential issues that could be at play.


Possible Causes of Upper Back Pain
1. Muscle Strain or Sprain: Overuse or improper posture during activities such as typing can lead to muscle strain. This is especially true if you are sitting for long periods without proper ergonomic support. Muscle strains can cause localized pain and tenderness, which may feel sharp or stabbing.

2. Nerve Compression: Conditions such as a herniated disc or spinal stenosis can lead to nerve compression in the cervical or thoracic spine. This can result in referred pain or sharp sensations in the upper back and shoulder area. If the nerve roots are irritated, it can cause pain that feels sharp or electric-like.

3. Myofascial Pain Syndrome: This condition involves trigger points in the muscles that can refer pain to other areas. The pain you experience when touching the skin may indicate that there are trigger points in the muscles around your shoulder blade or upper back.

4. Postural Issues: Poor posture, especially during prolonged activities like typing, can lead to muscle imbalances and pain. Slouching or leaning forward can strain the muscles in your upper back and neck, leading to discomfort.

5. Referred Pain from Internal Organs: Although less common, pain in the upper back can sometimes be referred from internal organs, such as the heart or lungs. However, this is usually accompanied by other symptoms.


Treatment Options
1. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide exercises to strengthen the muscles around your upper back and improve your posture. They may also use modalities such as ultrasound or electrical stimulation to alleviate pain.

2. Ergonomic Adjustments: If your pain worsens during typing, consider adjusting your workspace. Ensure that your chair and desk are at the correct height, and use ergonomic keyboards and mice to reduce strain on your upper back.

3. Stretching and Strengthening Exercises: Incorporating regular stretching and strengthening exercises for your upper back and shoulder muscles can help alleviate pain. Focus on exercises that promote flexibility and strength in the upper back, shoulders, and neck.

4. Heat Therapy: Applying heat to the affected area can help relax tense muscles and alleviate pain. A warm compress or heating pad can be effective.

5. Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and relieve pain. However, consult with a healthcare provider before starting any medication.

6. Alternative Therapies: Since you mentioned trying traditional Chinese medicine, other alternative therapies like acupuncture or chiropractic care may also provide relief for some individuals.

7. Rest and Activity Modification: If certain activities exacerbate your pain, it may be beneficial to modify those activities or take breaks to rest your back.


When to Seek Further Evaluation
If your symptoms persist despite conservative treatment, or if you experience additional symptoms such as numbness, weakness, or radiating pain down your arms, it is essential to seek further evaluation from a healthcare professional. Imaging studies, such as an MRI or X-ray, may be necessary to rule out structural issues or nerve compression.

In conclusion, upper back pain can arise from various causes, and understanding the underlying issue is crucial for effective treatment. Implementing ergonomic practices, engaging in physical therapy, and considering alternative therapies may help alleviate your symptoms. If the pain persists, further medical evaluation is warranted to ensure proper diagnosis and treatment.