Midback Pain

WHEN TO SEE YOUR DOCTOR

* Your pain lasts for more than three days.

* You are experiencing extremely severe or shooting pains.

* You also have numbness in your midback.

* You have heart disease.

What Your Symptom Is Telling You

What is it with "mid"? You could be having a midlife crisis or midriff bulge. (Or, worse, both at once!) But maybe the worst "mid" of all is midback pain. It hurts.

The most common cause of midback pain is strained ligaments and muscles. They're strained because they're chronically weak or because you've lifted something the wrong way. A less common cause is arthritis of the spine. Another possibility is scoliosis, a disease that alters the natural curve of the spine.

Because the gallbladder is close to the back, gallstones can also cause midback pain. So can heart disease, aneurysm (ballooning of an artery), pneumonia, peptic ulcers and kidney infections. Finally, there's a cause of midback pain that every mother remembers: pregnancy.

Symptom Relief

If your pain is severe or lasts more than three days, see your doctor. Problems like ligament tears, ulcers, kidney infections and gallstones require medical treatment.

Most of the time you can relieve midback pain on your own. Here's how.

Turn on shower power. For some folks with midback muscle pain, relief is only a hot shower away, according to Karl B. Fields, M.D., associate professor of family practice and director of the Sports Medicine Fellowship at Moses Cone Memorial Hospital in Greensboro, North Carolina. The heat from a shower increases blood flow to the area, which helps speed healing, he says. For severe pain, take at least two showers a day.

Try a mild water workout. You definitely won't work up a sweat with this routine: While water from your warm shower begins to soothe you, re-establish movement in your midback by gently twisting and bending for a few minutes. But don't move more than two to three inches from side to side and front to back, says Dr. Fields.

Go soak. Soaking in a whirlpool or tub in very warm water (104°F) for 20 minutes or so raises your internal temperature, causing painful muscle spasms to relax, says Dr. Fields.

Have a ball. This massage technique works best on mid and lower back pain, says Patrice Morency, licensed massage therapist and sports injury management specialist in Portland, Oregon, who works with Olympic hopefuls. Take two tennis balls, put them in a sock, and tie the end of the sock. Lie down on the sock, making sure a ball is on either side of the spine. Then gently roll your back up and down, allowing the tennis balls to massage your back until you get relief, she says.

Chill and twist. After wrapping an ice pack on the painful area with an elastic bandage, gently rotate your trunk from left to right. Repeat this movement several times a day, says Vert Mooney, M.D., professor of orthopedic surgery at the University of California, San Diego, Medical Center and director of the Spine and Joint Conditioning Center. "It's going to hurt a little at first," he says, "but you need to make sure that you get some movement each day. Complete rest is the wrong thing to do." Too much time in bed allows muscles to weak-en, he says. Do not do this exercise if it seems to make the pain worse.

Muscling Away Midback Pain

Once the pain has subsided, its time to start thinking about making your midback pain-proof. One of the best ways: strengthening your abdominals, says Dr. Fields. "If you don't maintain good abdominal strength, you get fatigued, and when you're fatigued, you're much more likely to get muscular injury," he says. Try these techniques.

Pelvic tilt. Stand up straight with your back against a wall. Slowly tilt your pelvis up, pressing the small of your back into the wall and hold for three to four seconds. Repeat ten times. "We're trying to tilt the pelvis into a more anatomically correct posture," says Dr. Fields.

Trunk twist. With your arms held out from your sides (or resting on your hips) and your hips held stationary, carefully turn your trunk, upper body and head from side to side 20 times.

Curl-ups. Lie on your back on the floor with your hands by your sides and your knees bent. Slowly curl your upper body, lifting your shoulders two to three inches off the floor. Lower and repeat. "It would help everyone to do 20 to 30 of these a day," says Dr. Fields.