Upper and Middle Back Pain: Causes and Treatment

Upper and middle back pain is a common complaint that affects millions of people worldwide. t can range from mild discomfort to severe pain, making it difficult to perform daily activities. This type of pain typically occurs in the area between the base of the neck and the bottom of the rib cage.  In this article, we’ll explore the top 12 causes of upper and middle back pain. In addition, we will also provide some best stretching and exercises for upper and middle back pain relief.

What Causes Upper and Middle Back Pain?

There are numerous possible causes of upper and middle back pain. Some of the most common culprits include:

1. Poor Posture

Let’s face it: in our modern, technology-driven world, maintaining good posture can be a real challenge. Whether you’re hunched over your smartphone, slouching at your desk, or curled up on the couch binge-watching your favorite series, poor posture is often the root cause of upper and middle back pain.

How it affects you: When you maintain poor posture for extended periods, the muscles in your upper and middle back are forced to work overtime. This constant strain can lead to muscle fatigue, tension, and eventually, pain.

What you can do:

• Set reminders to check and correct your posture throughout the day
• Invest in ergonomic furniture for your workspace
• Practice posture-strengthening exercises like shoulder blade squeezes and chest stretches

Remember, good posture isn’t just about looking confident – it’s about keeping your spine healthy and pain-free.

2. Muscle Strain

We’ve all been there – enthusiastically tackling a new workout routine or spending a weekend rearranging furniture, only to wake up the next day with a sore and achy back. Muscle strain is a common cause of upper and middle back pain, often resulting from overexertion or sudden, awkward movements.

How it affects you: Strained muscles can cause localized pain, stiffness, and sometimes even muscle spasms in your upper and middle back.

What you can do:

• Apply ice to the affected area for the first 48-72 hours to reduce inflammation
• After the initial period, switch to heat therapy to promote healing
• Gentle stretching and low-impact exercises can help once the acute pain subsides

Remember to listen to your body and avoid pushing yourself too hard, too fast.

3. Herniated Disc

While less common in the upper and middle back compared to the lower back, herniated discs can still occur in this region. A herniated disc happens when the soft inner core of a spinal disc pushes through its tougher outer layer, potentially irritating nearby nerves.

How it affects you: A herniated disc in the upper or middle back can cause sharp, shooting pain that may radiate to other areas. You might also experience numbness, tingling, or weakness in your arms or legs.

What you can do:

• Consult with a healthcare professional for an accurate diagnosis
• Follow a prescribed treatment plan, which may include physical therapy, medication, or in severe cases, surgery
• Practice good posture and ergonomics to prevent further damage

While a herniated disc can be scary, many people find relief with conservative treatments and lifestyle changes.

4. Osteoarthritis

As we age, the cartilage that cushions our joints can begin to wear down. This natural process, known as osteoarthritis, can affect the facet joints in your spine, leading to upper and middle back pain.

How it affects you: Osteoarthritis in the spine can cause stiffness, pain, and a decreased range of motion in your upper and middle back. The pain may worsen with activity and improve with rest.

What you can do:

• Maintain a healthy weight to reduce stress on your joints
• Engage in low-impact exercises like swimming or cycling to keep your joints mobile
• Consider supplements like glucosamine and chondroitin, but always consult with your doctor first

Remember, while osteoarthritis is a natural part of aging, there are many ways to manage its symptoms and maintain an active lifestyle.

5. Fibromyalgia

Fibromyalgia is a complex condition characterized by widespread musculoskeletal pain, often including the upper and middle back. While its exact cause is unknown, factors like genetics, infections, and physical or emotional trauma may play a role.

How it affects you: If you have fibromyalgia, you might experience chronic pain in your upper and middle back, along with fatigue, sleep problems, and mood changes.

What you can do:

• Work with a healthcare provider to develop a comprehensive treatment plan
• Practice stress-reduction techniques like meditation or yoga
• Maintain a consistent sleep schedule to improve overall symptoms

Living with fibromyalgia can be challenging, but with the right support and management strategies, many people lead fulfilling lives despite their condition.

6. Spinal Stenosis

Spinal stenosis occurs when the spaces within your spine narrow, potentially putting pressure on the nerves that travel through it. While more common in the lower back and neck, it can also affect the upper and middle back.

How it affects you: Spinal stenosis in the upper or middle back can cause pain, numbness, and weakness in your back, arms, or legs. Symptoms may worsen with prolonged standing or walking.

What you can do:

• Engage in exercises that flex your spine forward, which can help create more space for the nerves
• Consider physical therapy to improve your strength and flexibility
• In severe cases, your doctor may recommend surgical options

While spinal stenosis can be a serious condition, many people find relief through conservative treatments and lifestyle modifications.

7. Scoliosis

Scoliosis is a condition where the spine curves sideways, often taking on an “S” or “C” shape. While it typically develops during childhood or adolescence, it can also occur in adults.

How it affects you: Scoliosis can cause asymmetrical muscle strain in your upper and middle back, leading to pain and discomfort. In severe cases, it may also affect your breathing or heart function.

What you can do:

• Engage in exercises that strengthen your core and improve your posture
• Consider bracing or other treatments recommended by your healthcare provider
• In severe cases, surgery may be necessary to correct the spinal curvature

Remember, many people with mild scoliosis lead normal, active lives with proper management and care.

8. Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic condition where pressure on sensitive points in your muscles (trigger points) causes pain in seemingly unrelated parts of your body. This can often manifest as pain in your upper and middle back.

How it affects you: You might experience deep, aching pain in your upper and middle back that persists or worsens over time. The pain may intensify when you press on the trigger points.

What you can do:

• Try trigger point massage or dry needling to release the tight muscle knots
• Practice gentle stretching exercises to improve flexibility
• Consider stress-reduction techniques, as stress can exacerbate myofascial pain

While myofascial pain syndrome can be frustrating, many people find relief through a combination of physical therapies and stress management techniques.

9. Thoracic Outlet Syndrome

Thoracic outlet syndrome occurs when the blood vessels or nerves between your collarbone and first rib are compressed. This can lead to pain in your upper back, shoulders, and arms.

How it affects you: You might experience pain, numbness, and tingling in your upper back, shoulders, and arms. In some cases, you may also notice weakness in your hands or a change in color in your arm.

What you can do:

• Practice exercises that improve your posture and strengthen the muscles in your chest and upper back
• Avoid activities that require you to repeatedly raise your arms above your head
• In severe cases, your doctor may recommend surgery to relieve the compression

While thoracic outlet syndrome can be challenging to diagnose and treat, many people find significant relief with proper management.

10. Emotional Stress

Last but certainly not least, we can’t overlook the powerful impact of emotional stress on our physical well-being. Chronic stress can lead to muscle tension, particularly in the upper and middle back.

How it affects you: Stress-related back pain often manifests as a constant, dull ache in your upper and middle back. You might also notice increased muscle tension and difficulty relaxing.

What you can do:

• Practice stress-reduction techniques like deep breathing, meditation, or progressive muscle relaxation
• Engage in regular physical activity, which can help reduce stress and improve overall well-being
• Consider talking to a therapist or counselor to develop healthy coping strategies

Remember, taking care of your mental health is just as important as caring for your physical health when it comes to managing back pain.

11. Ankylosing Spondylitis

Ankylosing spondylitis is a type of inflammatory arthritis that primarily affects the spine. While it typically starts in the lower back, it can progress to the upper and middle back over time. This condition can cause the vertebrae in your spine to fuse together, leading to a rigid spine.

How it affects you: You might experience chronic pain and stiffness in your back, especially in the morning or after periods of inactivity. As the condition progresses, you may notice decreased flexibility in your spine and difficulty taking deep breaths if your rib cage is affected.

What you can do:

• Engage in regular exercise, particularly stretching and strengthening exercises for your back
• Practice good posture to maintain your spine’s flexibility
• Work with a rheumatologist to manage inflammation through medication
• Consider joining a support group to connect with others who understand your experience

Remember, early diagnosis and treatment of ankylosing spondylitis can help prevent or delay serious complications. If you’re experiencing persistent back pain and stiffness, especially if it improves with activity, don’t hesitate to consult a healthcare professional.

12. Gallbladder Disease

Surprisingly, issues with your gallbladder can sometimes manifest as pain in your upper and middle back. The gallbladder is a small organ located just below your liver, and when it’s not functioning properly, it can cause referred pain in unexpected areas.

How it affects you: Gallbladder-related back pain is often felt in the upper right quadrant of the back, sometimes extending to the right shoulder blade. This pain may be accompanied by other symptoms like nausea, vomiting, or pain in the upper right abdomen, especially after eating fatty foods.

What you can do:

• Keep a food diary to identify any trigger foods that worsen your symptoms
• Maintain a healthy diet low in saturated fats and high in fiber
• Stay hydrated by drinking plenty of water throughout the day
• Consult with a gastroenterologist if you suspect gallbladder issues

It’s important to note that gallbladder problems can be serious and may require medical intervention. If you’re experiencing persistent upper right back pain along with other digestive symptoms, it’s crucial to seek medical attention for proper diagnosis and treatment.

Stretching and Exercises for Upper and Middle Back Pain Relief

1. Cat-Cow Stretch: The Spinal Wave

The Cat-Cow stretch is a classic yoga-inspired movement that helps improve flexibility and mobility in the spine. It’s like giving your back a gentle massage from the inside out!

How to do it:

• Start on your hands and knees in a tabletop position. Make sure your wrists are directly under your shoulders and your knees are under your hips.
• As you inhale, drop your belly towards the mat, lift your chin and chest, and gaze up toward the ceiling. This is the Cow pose.
• As you exhale, draw your belly to your spine and round your back toward the ceiling, tucking your chin to your chest. This is the Cat pose.
• Repeat this flowing movement 5-10 times, moving slowly with your breath.

Pro tip: Focus on the sensation of each vertebra moving as you flow between the poses. This mindful attention can enhance the stretch and help you identify any areas of tension. Remember, the key is to move slowly and gently. Your back will thank you for this soothing, wave-like motion!

2. Thoracic Extension: Reach for the Stars

The Thoracic Extension is a fantastic stretch that targets the upper back muscles and can help improve your posture. It’s like giving yourself a big, expansive stretch after a long nap!

How to do it:

• Sit in a chair with your feet flat on the floor. Make sure it’s a sturdy chair that won’t tip backward.
• Place your hands behind your head, elbows pointing out to the sides.
• Gently arch backward over the chair, looking up at the ceiling. Imagine you’re trying to touch the wall behind you with your elbows.
• Hold for 5-10 seconds, feeling the stretch in your upper back.
• Slowly return to the starting position.
• Repeat 5-10 times.

Pro tip: As you arch back, take a deep breath in. As you return to the starting position, exhale. This coordinated breathing can enhance the stretch and help you relax into the movement.

Remember, this stretch should feel good. If you experience any pain or discomfort, especially in your lower back, reduce the range of motion or stop the exercise.

3. Shoulder Blade Squeeze: Embrace Your Inner Strength

The Shoulder Blade Squeeze is a simple yet effective exercise that strengthens the muscles between your shoulder blades. It’s like giving yourself a hug from the inside!

How to do it:

• Sit or stand up straight. Imagine a string pulling the top of your head towards the ceiling.
• Squeeze your shoulder blades together, as if you’re trying to hold a pencil between them.
• Hold for 5-10 seconds, feeling the engagement in your upper back muscles.
• Slowly release.
• Repeat 10-15 times.

Pro tip: Try doing this exercise at different times throughout the day. You can do it while waiting in line, sitting at a red light, or even during commercial breaks while watching TV!

Remember, quality over quantity. Focus on really engaging those muscles between your shoulder blades with each repetition.

4. Thread the Needle: Unravel the Knots

Thread the Needle is a yoga pose that provides a deep stretch for the upper back and shoulders. It’s like wringing out a sponge, releasing all that built-up tension!

How to do it:

• Start on your hands and knees in a tabletop position.
• Slide your right arm under your left arm, lowering your right shoulder to the ground.
• Rest your right cheek on the ground, feeling the stretch along the right side of your upper back.
• If it feels comfortable, you can extend your left arm forward for a deeper stretch.
• Hold for 20-30 seconds, breathing deeply.
• Slowly return to the starting position and switch sides.
• Repeat 2-3 times per side.

Pro tip: As you hold the pose, imagine your breath flowing into the areas of tension in your upper back, helping to release and relax those muscles.

Remember, the goal is to feel a gentle stretch, not pain. If you can’t lower your shoulder to the ground, that’s okay! Just go as far as is comfortable for you.

5. Seated Spinal Twist: Wringing Out the Stress

The Seated Spinal Twist is a gentle yet effective way to stretch the muscles along your spine. It’s like wringing out a wet towel, except the towel is your spine and the water is stress!

How to do it:

• Sit on the floor with your legs extended in front of you.
• Bend your right knee and place your right foot outside your left thigh.
• Place your left elbow on the outside of your right knee.
• Gently twist to the right, placing your right hand on the floor behind you for support.
• Look over your right shoulder, deepening the twist.
• Hold for 20-30 seconds, breathing deeply.
• Slowly return to the center and switch sides.
• Repeat 2-3 times per side.

Pro tip: As you twist, imagine your spine as a spiral staircase. With each breath, try to climb one step higher, gently increasing the twist.

Remember, the twist should come from your core, not by forcing your elbow against your knee. Keep the movement gentle and controlled.

6. Wall Angels: Your Guardian Angel for Good Posture

Wall Angels are a fantastic exercise for improving posture and strengthening the upper back muscles. It’s like making snow angels, but vertical and without the cold!

How to do it:

• Stand with your back against a wall, feet shoulder-width apart and about 6 inches from the wall.
• Press your head, shoulders, and lower back against the wall.
• Raise your arms up to shoulder height, elbows bent at 90 degrees, also pressing against the wall.
• Slowly slide your arms up the wall, keeping contact with the wall as much as possible.
• When your hands are above your head (or as high as is comfortable), slowly lower them back to the starting position.
• Repeat 10-15 times.

Pro tip: If maintaining contact with the wall is difficult, don’t worry! Start where you can and work on increasing your range of motion over time. Progress, not perfection!

When to Seek Medical Attention?

While most cases of upper and middle back pain can be managed with self-care and conservative treatments, some symptoms may indicate a more serious condition. Seek immediate medical attention if you experience:

• Severe pain that doesn’t improve with rest or medication
• Numbness, tingling, or weakness in your arms or legs
• Loss of bladder or bowel control
• Unexplained weight loss
• Pain accompanied by fever or chills

These symptoms may signal a more serious underlying condition that requires prompt medical evaluation and treatment.