B2B Blog

Upper and middle back pain can occur anywhere from the base of your neck to the bottom of your rib cage.

Your ribs attach to a long, flat bone in the center of the chest called the sternum and attach to and wrap around your back. If a nerve in this area is pinched, irritated, or injured, you may also feel pain in other places where the nerve travels, such as your arms, legs, chest, and belly.

The upper and middle back (called the thoracic spine) has:

• 12 vertebrae. These bones attach to your rib cage. They make up the longest part of your back.
• Discs that separate each vertebra and absorb shock as you move.
• Muscles and ligaments that hold the spine together.

See a picture of the spine.

Upper and middle back pain is not as common as low back pain or neck pain, because the bones in this area of the back don’t flex or move as much as the bones in your lower back or neck. Instead, they work with the ribs to keep the back stable and help protect vital organs, such as the heart and lungs.

The most common types of mild to moderate neck pain usually respond well to self-care within two or three weeks. If neck pain persists, your doctor might recommend other treatments.

Medications

Your doctor might prescribe stronger pain medicine than what you can get over-the-counter, as well as muscle relaxants and tricyclic antidepressants for pain relief.

Therapy

Physical therapy.

 A physical therapist can teach you correct posture, alignment and neck-strengthening exercises, and can use heat, ice, electrical stimulation and other measures to help ease your pain and prevent a recurrence.

Transcutaneous electrical nerve stimulation (TENS).

 Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain.

Traction. 

Traction uses weights, pulleys or an air bladder to gently stretch your neck. This therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially pain related to nerve root irritation.

Short-term immobilization. 

A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck. However, if used for more than three hours at a time or for more than one to two weeks, a collar might do more harm than good.

Surgical and other procedures

Steroid injections. 

Your doctor might inject corticosteroid medications near the nerve roots, into the small facet joints in the bones of the cervical spine or into the muscles in your neck to help with pain.

Surgery. 

Rarely needed for neck pain, surgery might be an option for relieving nerve root or spinal cord compression.

Neck pain is a common complaint. Neck muscles can be strained from poor posture — whether it’s leaning over your computer or hunching over your workbench. Osteoarthritis also is a common cause of neck pain.

Rarely, neck pain can be a symptom of a more serious problem. Seek medical care if your neck pain is accompanied by numbness or loss of strength in your arms or hands or if you have shooting pain into your shoulder or down your arm.

Your neck is flexible and supports the weight of your head, so it can be vulnerable to injuries and conditions that cause pain and restrict motion.

Neck pain causes include:

Muscle strains. 

Overuse, such as too many hours hunched over your computer or smartphone, often triggers muscle strains. Even minor things, such as reading in bed or gritting your teeth, can strain neck muscles.

Worn joints. 

Just like the other joints in your body, your neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between your bones (vertebrae) to deteriorate. Your body then forms bone spurs that affect joint motion and cause pain.

Nerve compression. 

Herniated disks or bone spurs in the vertebrae of your neck can press on the nerves branching out from the spinal cord.

Injuries. 

Rear-end auto collisions often result in whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck.

Diseases. 

Certain diseases, such as rheumatoid arthritis, meningitis or cancer, can cause neck pain

Neck pain can feel like any of the following:

• Stiff neck that makes turning the head difficult
• Sharp or stabbing pain in one spot
• Soreness or tenderness in a general area
• Pain that radiates down into the shoulders, arms, or fingers; or radiates up into the head

In some cases, other symptoms associated with the neck pain are even more problematic, such as:

• Tingling, numbness, or weakness that radiates into the shoulder, arms, or fingers
• Trouble with gripping or lifting objects
• Problems with walking, balance, or coordination
• Loss of bladder or bowel control

Chill it. 

 “Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes,” she says. After 48 hours, you can switch to heat if you prefer.

Keep moving.

“Our spines are like the rest of our body — they’re meant to move,” says Southlegpaincenter. Keep doing your daily activities. Make the beds, go to work, walk the dog.

Once you’re feeling better, regular aerobic exercises like swimming, bicycling, and walking can keep you — and your back — more mobile.

Stay strong.

“They help you maintain the proper posture and alignment of your spine,” Southlegpaincenter says. Having strong hip, pelvic, and abdominal muscles also gives you more back support.

Avoid abdominal crunches, because they can actually put more strain on your back.

Stretch. 

Don’t sit slumped in your desk chair all day. Get up every 20 minutes or so and stretch the other way. “Because most of us spend a lot of time bending forward in our jobs, it’s important to stand up and stretch backward throughout the day,”

Think ergonomically. 

Design your workspace so you don’t have to hunch forward to see your computer monitor or reach way out for your mouse.

Use a desk chair that supports your lower back and allows you to keep your feet planted firmly on the floor.

Watch your posture. 

Slumping makes it harder for your back to support your weight. Be especially careful of your posture when lifting heavy objects.

Wear low heels. 

Exchange your four-inch pumps for flats or low heels (less than 1 inch). High heels may create a more unstable posture, and increase pressure on your lower spine.

Not all leg pain derived from low back problems presents the same way. Some typical descriptions of leg pain and accompanying symptoms include:

Burning pain. 

Some leg pain is experienced as a searing pain that at times radiates from the low back or buttocks down the leg, or it may present as intermittent pain that shoots from the lower back down the leg and occasionally into the foot. advertisement

Leg numbness or tingling. 

Anyone who has had a leg or foot “fall asleep” and then gradually return to normal can imagine what numbness in a leg would feel like. Not being able to feel pressure, or hot or cold, is unnerving.

Weakness (foot drop) or heaviness. 

Here, the predominant complaint is that leg weakness or heaviness interferes significantly with movement.

Patients with foot drop are unable to walk on their heels, flex their ankle, or walk with the usual heel-toe pattern.

Constant pain. 

This type of pain is normally felt in the buttock area, so it is not technically leg pain but it may accompany some form of pain felt in the legs. It may also be pain that occasionally radiates past the buttock into the leg.

Positional leg pain. 

If leg pain dramatically worsens in intensity when sitting, standing, or walking, this can indicate a problem with a specific part of the anatomy in the low back.

After reading about the lumbar spine and types of lumbar disc injuries, let’s get into lumbar disc injury recovery time and slipped disc exercises.

Lumbar disc injuries can heal even up to 2 years after an injury.

The lumbar disc injury recovery time can be positively affected by the following factors:

1. Working with a physical therapist who specializes in lumbar disc injuries and exercises
2. Reducing inflammation of your lumbar disc injury in the first 2-4 weeks
3. Performing daily slipped disc exercises prescribed by your physical therapist
4. Reducing the stress and work load for the lumbar disc as it heals
5. Stopping smoking, which delays healing time by 30%

A complete and thorough assessment by a qualified physical therapist is the first step in a comprehensive lumbar disc injury treatment plan. 

There are many types of Lumbar Disc Injuries, Texas, and as I mentioned earlier, people call them funny names like slipped disc or blown disc.

Here are the main types of Lumbar Disc Injuries, Texas.

Herniated Lumbar Disc Injury, Texas      

With this type of injury, the outer shell of the lumbar disc called the annulus sprains and eventually gets a small tear in it. The inner portion of the disc called the nucleus is then able to move out through the tear.

Prolapsed or “Bulging” Lumbar Disc Injury, Texas

Unlike the herniated lumbar disc injury, with a prolapsed lumbar disc injury, the outer wall of the disc (the annulus) is still intact. Don’t assume that a lumbar disc prolapse is the cause of your lumbar pain.

Degenerative Disc Injury, Texas

All of us will have degenerative disc injuries at some point in our life. Degenerative is just a fancy word for aging. Worry about degeneration of the lumbar discs as much as you worry about your hair going grey, which I hope is not much at all!

Treatment for lumbosacral facet syndrome usually includes a multidisciplinary approach.  If the diagnosis is uncertain, consideration is given to performing diagnostic medial branch blocks.

Non operative Treatment

Non operative management includes oral medications such as NSAIDs, acetaminophen, and oral steroids during acute flares. Additionally, weight loss and physical therapy have demonstrated successful outcomes.

More invasive non operative modalities that can be considered include a CT-guided aspiration.  The literature is controversial with respect to the overall effectiveness of this modality.  Patients should also be counseled regarding the risk of facet cyst recurrence and return of symptoms even after the aspiration is performed.

Surgical Treatment

Indications for surgical intervention include: 

• Symptoms refractory to non operative modalities (e.g. 3 to 6 month trial) 
• Large associated synovial facet cyst correlating with clinical exam and presentation
• Laminectomy with decompression is the classic first line treatment for symptomatic, intraspinal synovial cysts
• The literature also supports the utilization of facetectomy, decompression, and instrumented fusion (as opposed to a simple “lami decompression”)

Minimally invasive techniques

Other management modalities include facet injections, radiofrequency denervation of the medial branch nerves.