Upper Back Pain

A female patient, 38 years old, was recently experiencing pain in the upper right hand side of her back. She said for about two days, every time she moved in a certain way it hurt. Especially when bending down.

One common cause of constant aching visceral pain is gall bladder, which can present as right upper shoulder or back pain. Upper back pain may also be triggered by sports, improper lifting, bending, or twisting. When pain develops suddenly or related to direct trauma, stop all strenuous activities to prevent aggravation of the injury and increasing the damage. Muscle spasms may develop as strained muscles swell after injury. If related to trauma bruising may occur. Rest and gentle stretching will help the muscles relax.

If the pain is in both sides of the upper back, tight pectoral muscles can be the cause. Both the pectoral minor and pectoral major, can pull your shoulders forward, throwing off the mechanics of all the other muscles, creating a tight capsule of the shoulder joint.

I have seen this in my clinic where it presents similar to arthritis, however slow and gentle pectoral stretches, and eventually stretching the latissimus dorsi muscles will begin to alleviate the snapping, crackling and popping. Another muscle that should be looked at with similar problems would be the levator scapulae muscle which affects both your neck and shoulder biomechanics.

Bad posture is also a common cause. Over time, poor posture from hours in front of the computer will strain the upper back muscles. Most back pain is related to muscle strain rather than injury to the spine.

Under most circumstances applying ice will reduce swelling and pain and will accelerate your healing. Once initial pain has eased a rehabilitation program of upper back strengthening exercises and stretching is recommended to help prevent re-injury and pain.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Therapeutic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT


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