Upper Back Problems: Doctor Answers Patient Questions
On this page:
- > Questions: Pain while studying, Neck Pain and a tingling arm
- Questions: Back Pain and Sleep, Burning Pain under shoulder blade
- Questions: Thoracic pain after car accident, Back Pain and breast size
The following explanations, insights, and advice about upper back problems are provided by Douglas J. Hendricks, MD, a physical medicine and rehabilitation specialist and a contributing author for Spine-health.com.
Patients frequently e-mail us questions about upper back problems, exercises and other treatments, and while we don’t provide individual responses, periodically, Dr. Hendricks and other contributors to Spine-health.com will take time to respond to the themes from more frequently asked questions and we publish the responses in this section of the site.
Please understand that the following responses to questions about upper back problems represent the opinion of one physician, and are intended for informational purposes only and not as a substitute for professional medical help or advice.
Severe upper back pain while studying
The Question:
I’m having some seriously bad back pains. I’m 16 years old and recently (over the last few months) my back has been hurting quite badly. Usually during the morning its fine, but by about 5:00 it gets really bad, especially right at the spine in the middle towards my upper back, just in between my shoulder blades. When I come home and sit in a chair or even try to go to sleep, it’s awful. Sitting on a chair makes it feel really bad and I’ve resorted to slouching and moving around to make it bearable. Also when I stand and do simple things, like ironing or drawing or even just picking something up, it’s become really, really bad. When I go to sleep, it takes about 30 minutes before the pain calms down.
The pain started when I used to review for exams. I would lean against the backboard on my bed or I would sit up on my chair for long periods of time doing work, sometimes really early into the morning. However I’ve stopped doing this and I’ve been working on a chair or sofa and I’ve quit weightlifting for the last 2 months, but things just seem to be getting worse. Sitting on a chair in school is fine, and I feel no pain there, it’s only when I get home when the problems occur. Can you give me any information about what I could do to prevent or stop the pain?
Doctor's Response:
Given your young age and the severity of your pain, I suggest you go see your regular doctor, a physiatrist or other spine specialist. A physiatrist is a Medical Doctor (MD) or Doctor of Osteopathy (DO) who specializes in a wide variety of non-surgical treatments for the musculoskeletal system, such as physical therapy, medications, massage and interventional medicine (i.e. injections). You need a thorough spine examination with x-rays. You may just have muscular pain due to the poor posture often assumed during long hours of studying.
Until you are seen by a physician, I recommend avoiding those positions/postures that cause the back pain to flare up. You may try Tylenol, low-dose Aleve, or ibuprofen and ice/heat. Seeing a chiropractor may also be beneficial.
Neck pain followed by numbness/tingling in arm
The Question:
I am a newly commissioned military officer. While conducting morning physical training six months ago, our unit did a motivational pushup exercise where we placed our legs onto a partner’s upper back/neck. Each in turn had someone else's legs (from about the knee) on top of their neck/back. My partner weighed in excess of 200 pounds while I weigh all of 122 and while attempting to push myself back to the up position, I felt something release in my upper back/neck...Almost like pressure was being relieved and then a very sore neck area incurred. I attempted to do a few more repetitions but couldn't.
After "PT" that morning, I had severe neck and joint pain, and to this day I have numbness/tingling in my right arm and shoulder after waking and the same symptoms immediately following any type of physical activity. This includes sit-ups, pushups, lifting and anything over the head. I am scheduled to have exploratory surgery done on my right shoulder because the doctors think it's in the shoulder but haven't found anything on MRIs… It has been 6 months since this injury occurred and I can do absolutely no exercises without having this numbing sensation in my right arm that remains there until I crack my neck. I know something isn't right. X-rays and MRIs were negative on the shoulder. What can you recommend for me?
Doctor's Response:
You need a cervical MRI (image of the neck) and an appointment with a spine specialist to discuss the results and potential avenues of treatment. I suspect you have a pinched nerve in your neck, possibly from a herniated disc. The herniated disc material can press on a cervical nerve, causing arm pain, numbness and tingling, and even muscle weakness along the nerve pathway down the arm. The MRI scan should detect the presence of any disc bulge, herniated disc or similar pathology.
In the short term, over-the-counter ibuprofen or Aleve may be helpful. A short course of oral steroids, about one week, may provide pain relief as well until a definitive diagnosis can be made. All treatments for a cervical herniated disc are essentially designed to help resolve the arm pain, and usually the weakness and numbness/tingling will resolve with time. Most symptoms can be successfully treated with conservative treatments, such as physical therapy and exercise, chiropractic manipulation, bracing, activity modification, and other pain medications or injections.
