Don’t ignore that Upper back pain

Pain at the upper back is not as common as the pain at the lower back.  It is often ignored as the source of pain because it presents commonly with neck or shoulder pain.

The upper back is an area of transition. It sits in between our neck and lower back. It transmits force between our shoulder blades and our arms. There are 24 ribs connecting onto the spinal column of the upper back, transmitting movements to the chest.

Being in this unique position, dysfunction of any of these body parts may give rise to upper back pain. Likewise, pain in the upper back may radiate into a wider area. For example, dysfunction in the upper back sometimes radiates pain into the chest, mimicking pain from a heart disease. Pain may even be felt when breathing.

Why do I get upper back pain?

Most upper back pain are muscular in nature, and are likely related to accumulated muscle imbalance over time.

The nature of most of our daily activities is mostly forward dominant, i.e. the tasks involve upper limb movements in front of the body, such as computer work, writing, cooking, washing etc. With the arms largely forward most of the time, the chest muscles in front of our body hardly ever get stretched.

As a result, they get tighter and shortened over time. In contrast, the upper back muscles get elongated and weakened over time. This muscle imbalance will gradually accumulate and lead to upper back pain.

This common pattern of muscle imbalance may be reinforced by improper gym exercises. Big bulky chest muscles are the dream of many gym-goers. It is a common sight to see people in the gym spending disproportionate amount of time pumping the chest muscles and very little attention to the upper back or scapular muscles.

Over time, the same muscle imbalance occurs, leading to upper back pain.  Sounds familiar? If you are a gym goer, you may want to shake up your gym routine.

How can I reduce upper back pain?

Muscular upper back pain can usually be relieved by reducing the muscle tension. The easiest way is to apply a heat pack over the painful area for 15-20 minutes.  Warmth is effective in relaxing the muscles.

Another quick fix that can be done at home is to use a tennis ball for self-massage. All you need is a wall and a tennis ball. There are a lot of specially made massage balls available on the market for this purpose.

To release the muscles, first identify the spinal column that runs down the centre of your upper back, then reach behind to apply the ball right next to the spinal column. That is where are muscles are located. Next, press the ball into the wall with your body weight. Bend and straighten the knees to move the ball up and down on your upper back.

Look for areas that are more tender and work more on those regions. That is where the tightness is located. Now the ball has become your personal masseuse at home! You can adjust the pressure by changing the amount of body weight on the ball.

It is important that the pressure should not be put on the spinal column itself, but on the muscles located next to the spine. Spend about 5-10 minutes, once or twice a day with this self massage technique. Warning! Excessive pressing will lead to soreness the next day.

Relieving the muscles is a quick fix for pain and the effect is often temporary as it does not address the underlying muscle imbalances. In the long run, posture changes and specific strengthening exercises need to be done to keep the pain at bay.

Exercises to maintain a pain-free upper back

Stretching of the chest muscles is very important to maintain good posture in the upper back and the shoulder girdles. So stretch the chest muscles daily!

If you do a lot of chest muscle strengthening exercises, you should do additional chest stretch after strengthening. Examples of chest stretch can be readily found on the Internet. Try different variations and make sure that the stretching feeling is felt in front of the upper chest during the stretch and hold the position for 15-30 seconds each time. Repeat three times for each side. Stop if it gives you any discomfort beyond mild stretching feeling.

Relook into your gym routine and include exercises that target the trapezius muscles. Exercises that work the trapezius muscles would be rows, one arm rows, lats pull down etc. Try to also consciously flex or contract your trapezius muscles in most upper body exercises work the scapular muscles.

So don’t ignore that upper back pain, recognise it early and you don’t have to suffer in silence.  Upper back pain is often a result of muscle imbalance and if address appropriately, it is a very treatable condition by attending Singapore physio sessions.

Darek Lam

Senior Principal Physiotherapist

Shirley Le, writes in detail and this shows in her meticulous work with her patients. She constantly upgrades her clinical skills to be at the forefront of her physiotherapy practice.
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