Upper Back Pain

WHEN TO SEE YOUR DOCTOR

* Your upper back pain radiates to the front of your chest, lower part of your rib cage or your abdomen.

* You have a family history of cardiovascular disease.

* You have no idea why your upper back hurts.

What Your Symptom Is Telling You

Think of upper back pain as the voice of your mom. Remember her urgings not to slouch? Most of the time, that's what your upper back is trying to tell you when it hurts: Please stand up straight.

Poor posture can lead to weakened muscles and strained joints and ligaments, setting the stage for more upper back pain.

Overusing the muscles of the upper back can also cause pain. (If you've been painting the ceiling in your den, for example, you know why your back hurts.) And if you have particularly large breasts, just straining to stand up straight can cause pain in the upper back.

More serious causes of upper back pain include osteoporosis, a ruptured spinal disk and injury. Osteoporosis is a disease in which the bones become porous and fragile—so fragile, that a vertebrae can shatter, just from the spine's own weight. Rupturing a disk in the upper back is, fortunately, quite rare, but it can generate angry bolts of pain. As for injuries, a traffic accident can cause whiplash, which severely strains upper back muscles in addition to damaging the neck.

Finally, heart disease or other serious illnesses can announce themselves in the form of upper back pain.

Among the most common areas of pain are the trapezius—the large, triangular-shaped muscles of the upper back—and the shoulder blades.

Symptom Relief

If your upper back has been troubling you and you're not sure why, it's a good idea to have your doctor look at it for diagnosis and treatment. If you have osteoporosis or heart disease, or if you've sustained an injury to your back, you definitely need to be under a doctor's care.

If your back hurts because of a mechanical problem—strain, underuse or poor posture, for example—here are a few things you can do on your own.

Handle the pain yourself. One minute of self-massage each hour in the problem area of your upper back should help provide relief for muscle spasm, says Morris Mellion, M.D., past president of the American Academy of Family Physicians and medical director of the Sports Medicine Center in Omaha, Nebraska. "Deep massage over the most exquisitely tender spot should produce results a short time later," he says. Just reach across with your hand to the opposite shoulder and rub.

Get the knead you need. Gently kneading the trapezius muscle relieves pain by stretching the area and increasing circulation, says Patrice Morency, licensed massage therapist and sports injury management specialist in Portland, Oregon, who works with Olympic hopefuls. Have a friend or spouse first knead the muscles on the left and then the right side of your upper back with the palms of their hands. They should press repeatedly and gently in the same way a cat kneads with its paws.

Elbow away pain. Another soothing massage technique for upper back pain employs the use of someone's elbow. Simply have your assistant press the point of their elbow gently into your trapezius muscle for between 15 and 30 seconds. Release, and then repeat, says Morency. Pressing on the area slows the blood supply briefly and releasing it floods the area with blood and oxygen, often allowing a muscle in spasm to relax, she explains.

Try a sports bra. Women with large breasts may experience immediate relief from upper back pain after shedding their everyday bras for a sports bra that has better support, says 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.

Hold your head up. When reading at your desk, instead of bringing your eyes—and head—to your paper, try bringing your paper to your eyes. "People are constantly using poor body mechanics when they read," says Hubert Rosomoff, M.D., D.Med.Sc., medical director of the University of Miami Comprehensive Pain and Rehabilitation Center in Miami Beach. "Instead of holding their heads erect, they tend to scrunch their heads and necks forward on their shoulders."

Hold the phone. Rather than propping the phone between your head and shoulder—which can strain the muscles in your upper back—hold the phone in your hand. Or better yet, buy a headset or speaker phone, says Dr. Rosomoff.

Improve your posture. Poor posture eliminates the natural, weight-supporting S curve of your back, often weakening the muscles of the upper back and making them susceptible to strain, says Fred Allman, Jr., M.D., an orthopedic surgeon and director of the Atlanta Sports Medicine Clinic. Healthy posture—chest out, stomach in, buttocks tucked under—restores that S, making it easier on the muscles of your upper back. If you frequently suffer from upper back pain, ask your doctor to evaluate your posture and—if appropriate—to recommend someone who can teach you exercises that will restore your posture.

Pump up your upper back. You never know when you're going to wrench your upper back or suffer a whiplash injury. But if your upper back and neck muscles are strong, you're less likely to suffer a severe pull or tear in that area, doctors say. "If those muscles support you, then part of that stress is absorbed by the muscle, and not by the bone or the ligaments or the other tissues," says Dr. Fields. You can strengthen your upper back with this simple exercise: hold a can of soup in each hand, keeping your arms straight by your side. Lift your shoulders straight up toward your ears for a two count, then pull the shoulders back, pinching your shoulder blades together. Relax and repeat 8 to 12 times.

See also Lower Back Pain