Upper Back Pain: When to Seek Further Medical Evaluation - Orthopedics

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Upper back pain can be a frustrating and debilitating condition, especially when it persists for more than a month. Your description of the pain being localized to the right upper back and the presence of chest pain raises several important considerations.
Firstly, it is essential to understand that upper back pain can arise from various causes, including muscular strain, ligament sprains, herniated discs, or even conditions affecting the thoracic spine. In your case, the initial diagnosis of myofascial pain syndrome (筋膜炎) suggests that the pain may be related to muscle tension or trigger points in the muscles of the upper back. However, if you have been taking medication for over a week without any improvement, it may be time to seek further medical evaluation.

The chest pain you mentioned is particularly concerning. While it could be referred pain from the upper back, it is crucial to rule out any serious underlying conditions, such as cardiac issues or pulmonary problems. Chest pain can sometimes be a sign of a heart condition, especially if it is accompanied by other symptoms like shortness of breath, dizziness, or radiating pain to the arm or jaw. Therefore, if your chest pain persists or worsens, it is advisable to seek immediate medical attention.

Given that your symptoms have not improved with conservative treatment, it would be prudent to consider further evaluation. A visit to a larger medical facility or a specialist, such as a physiatrist or orthopedic surgeon, may provide you with a more comprehensive assessment. They may recommend imaging studies, such as X-rays or MRI, to evaluate the structures of your spine and rule out any significant abnormalities. Additionally, they may perform a thorough physical examination to assess your range of motion, strength, and any neurological deficits.

In terms of treatment, if myofascial pain syndrome is confirmed, physical therapy could be beneficial. A physical therapist can provide targeted exercises to strengthen the muscles of the upper back, improve flexibility, and reduce pain. They may also use modalities such as ultrasound, electrical stimulation, or dry needling to alleviate muscle tension. Furthermore, if there are any postural issues contributing to your pain, a therapist can help you address those as well.

In summary, while myofascial pain syndrome is a common cause of upper back pain, the persistence of your symptoms and the presence of chest pain warrant further evaluation. It is essential to rule out any serious conditions and to explore more effective treatment options. Seeking care from a larger medical facility or a specialist can provide you with the comprehensive evaluation and treatment plan you need to address your pain effectively. Remember, early intervention can often lead to better outcomes, so do not hesitate to seek the care you need.