Anatomy Of The Upper Back And Middle Back
Your upper and middle back starts from just below your neck and extends to about 5 inches below your shoulder blades.
Your thoracic spine gives your upper body strength and stability and helps you lift heavy objects. Your rib cage also protects many vital organs like your heart, kidneys, and lungs. According to Dr. William Blahd on WebMD, vertebrae in your middle back attach to your ribs which wrap around to your chest and are attached to your sternum.1
You have discs in between the vertebrae in your spine to absorb shocks and prevent the bones rubbing together. Also, many muscles between your ribs called intercostal muscles provide strength to your upper body and assist in breathing. There are also many nerve fibers that are attached to your spinal column.
An injury to the ligaments, ribs, nerves, or muscles in your middle back can affect your back and also radiate to other areas of your body. For example, back rib damage could also cause pain that wraps around your ribs to the front of your chest and breastbone. Or, the pain may radiate to your shoulder blade, neck, or even abdomen.
Getting A Diagnosis For Upper Back And Chest Pain
Any sudden onset of unexplained chest pain that lingers needs to be evaluated by a doctor. When evaluating upper back and chest pain, a doctor typically aims to rule out cardiac causes before checking other potential causes, such as an injury to the muscles, ribs, or spine.
A trained medical professional can accurately diagnose the cause of upper back and chest pain. Once an accurate diagnosis is found, an effective treatment plan can begin.
Signs And Symptoms Of Angina
You may feel pressure, squeezing, burning, or tightness in your chest. You may also have pressure, squeezing, burning, or tightness in your arms, shoulders, neck, jaw, throat, or back.
Some people may have different symptoms, including shortness of breath, fatigue, weakness, and back, arm, or neck pain. This applies particularly to women, older people, and people with diabetes.
You may also have indigestion or be sick to your stomach. You may feel tired. You may be short of breath, sweaty, lightheaded, or weak.
Some people have angina when they are exposed to cold weather. People also may feel it during physical activity. Examples are climbing stairs, walking uphill, lifting something heavy, or having sex.
Learn about the symptoms and causes of angina pectoris.
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Problems With Spinal Discs
A herniated, ruptured, or slipped disc in the spine can cause middle back pain when moving your upper body. The back pain may feel worse when twisting or bending at the waist and may cause neck pain.
The Journal of Manual and Manipulative Therapy found that injuries to the discs in the cervical spine can cause pain that spreads to the upper thoracic spine. The type of pain in the thoracic area caused by spinal issues is described as severe, intense, debilitating back pain. These injuries can affect nerves that can also cause headaches and other neurological problems.10
Researchers from the University of Maryland report that a herniated thoracic disc can cause intense sharp pain that happens suddenly. However, you may have a herniated disc without back pain. This can happen if the ruptured disc presses on a spinal nerve and this can result in any of the following symptoms:11
- Muscle weakness
- Numbness in one or both legs
- Pain that travels through your body
According to a report in the journal International Surgery, a thoracic disc herniation can also cause chronic abdominal pain. The researchers suggested that it is possible to mistake symptoms of irritable bowel syndrome for thoracic pain that radiates from the middle back.12
Treating Chest And Back Pain
Treatment for your chest and back pain depends on what is causing it. An accurate diagnosis is essential to get relief from your symptoms.
For digestive conditions, you may need to alter your diet or take medication to help manage symptoms.
To treat heart conditions, you may need to make lifestyle changes, diet alterations, and take medication.
For other causes of chest or back pain, your provider will give you clear instructions on how to treat or manage your condition.
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Chest Tightness And Back Pain Other Causes
Chest tightness and back pain can be a sign that you need help. Many of the diseases that affect us are due to bad habits we have practiced for years. You may use medicines to help, but the best approach is to change the way you eat and live.
Medicine will help, but you will continue to experience many sicknesses unless you change. If you cut out those things that make you ill, you will soon cease to experience such issues.
How Is Noncardiac Chest Pain Treated
Effective treatment depends on identifying the cause of your noncardiac chest pain. Some options include:
Acid reflux treatments
If your noncardiac chest pain is, like most peoples, from GERD, treatment is usually simple and effective. Proton-pump inhibitors are the most commonly used medicine to treat GERD. PPIs reduce the amount of stomach acid that your glands secrete, which also allows ulcers and acidic corrosion to heal. Treatment usually begins with a high dosage to control your symptoms, then continues with a low dosage for two to four months. PPIs are about 90% effective in treating GERD and its side effects. If they are ineffective, it probably means that your NCCP is caused by something else.
The next most common and effective treatment for noncardiac chest pain is a medicine that blocks the pain signals. These are usually from a class of drugs known as tricyclic antidepressants , used in much lower dosages than they are used to treat depression. If side effects prevent you from tolerating TCAs, other categories of antidepressants might work. Selective serotonin reuptake inhibitors have shown some promise in treating NCCP, although they are less well-established than TCAs.
Emotional and behavioral therapies
A note from Cleveland Clinic
Last reviewed by a Cleveland Clinic medical professional on 04/04/2022.
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What Are The Causes Of Chest Pain
Chest pain can be a symptom of many different conditions, some of which are more serious than others. Its best to seek medical attention for any chest pain in case it is heart-related.
Common non-cardiac causes of chest pain include:
- indigestion or reflux when stomach acid rises up the food pipe, and causes a burning pain in the chest
- inflammation where the ribs join the breast bone
- chest infections such as bronchitis and pneumonia
- anxiety or panic attack these may also cause dizziness, heart palpitations, sweating and breathlessness and can last for up to 20 minutes.
Common cardiac causes of chest pain include:
- angina pain caused by poor blood flow to the heart muscle, which usually occurs when the heart needs to work harder than usual. This might be due to exercise, anxiety or emotion, cold weather, or following a large meal. The pain is usually short lived and eases with rest.
- heart attack when the blood flow to a part of the heart muscle is blocked. Chest pain caused by a heart attack usually does not go away with rest, and urgent medical attention is necessary.
Less common causes of chest pain include:
- shingles an infection that typically causes pain before a skin rash appears
- mastitis usually caused by a breast infection related to breastfeeding
- a pulmonary embolism a blockage in the blood vessel that carries blood from the heart to the lungs. You may have sharp, stabbing chest pain that is worse when you breathe in.
Treatment If Back Pain Is Severe Or Lasts A Long Time
If your back pain doesn’t get better or is severe, your doctor may recommend:
- Prescription medicines.
These may include:
- Muscle relaxants to help reduce pain and muscle tension and help you move better. These can help with severe muscle spasms that happen when the back pain starts .
- Antidepressants, such as duloxetine. They can help treat long-lasting back pain.
- Prescription pain medicines.
- Steroid shots.
They may help reduce swelling and relieve pressure on nerves and nerve roots. But there is little evidence showing that these shots can help control back pain.
In some cases, a back brace may be used to support the bones in the spine after a fracture.
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Can Back Pain Cause Chest Pain
If you experience back pain and chest pain at the same time, then you might be quite alarmed! However, upper back and chest pain together can occur for a number of reasons. Symptoms can differ depending on what is causing your discomfort. Talk to your doctor if you noticed back pain first before the chest pain. Whether you have mild back and chest pain or start to notice a sharp, stabbing pain, you will want to keep track of your symptoms to share with your doctor. at AICA Orthopedics can perform a physical examination to determine why you have pain from your back to chest.
How Is The Cause Diagnosed
Because there are many possible causes for chest and shoulder pain, diagnosis can be challenging.
Your doctor will take a full medical history to find out about any other health conditions you may have. Theyll also ask if your family members have heart disease or other types of conditions.
Your doctor will ask about your symptoms, when they started, how long they lasted, and if they changed.
Once your doctor knows more about your symptoms and any other health conditions, theyll do a physical exam and listen to your heart and lungs.
There are many diagnostic tests your doctor may use to determine whats causing your shoulder and chest pain. Common diagnostic tests include:
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The Real Cause Behind Upper Back Pain And Chest Tightness
Do you struggle with chronic upper back and neck pain? Is it difficult to hold good posture without discomfort? Perhaps you even have trouble sleeping at times because of the discomfort. Do you also feel tightness in your chest and shoulders?
If youre nodding your head yes to all of these questions, you may have a condition called upper crossed syndrome. While back pain in general certainly isnt uncommon, the upper crossed syndrome is a lesser-known condition that can greatly contribute to back pain, especially if its accompanied by tightness in the chest and shoulders. And, when left untreated, it only continues to progress to a worse state.
Dont worry: if you do fall into this category, the encouraging news is that most cases are completely treatable with the right diagnosis, patience, and consistent conservative care. Lets explore the causes behind this condition and tangible steps to take toward your healing.
It Could Also Be Stress
Along with sub-par posture, strain in the muscles around the neck and shoulders or between the shoulder blades can be multi-factorial, says Kaliq Chang, MD, an interventional pain management specialist at the Atlantic Spine Center in West Orange, New Jersey. Most notably: stress, strenuous exercise, and sleeping with your neck in a weird position.
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How To Treat Your Chest Pain
Sit, stay calm, and rest. Your symptoms will often go away soon after you stop activity.
If you are lying down, sit up in bed. Try deep breathing to help with stress or anxiety.
If you do not have nitroglycerin and your symptoms are not gone after resting, call 911 or the local emergency number right away.
Your health care provider may have prescribed nitroglycerin tablets or spray for severe attacks. Sit or lie down when you use your tablets or spray.
When using your tablet, place the pill between your cheek and gum. You can also put it under your tongue. Allow it to dissolve. Do not swallow it.
When using your spray, do not shake the container. Hold the container close to your open mouth. Spray the medicine onto or under your tongue. Do not inhale or swallow the medicine.
Wait for 5 minutes after the first dose of nitroglycerin. If your symptoms are not better, are worse, or return after going away, call 911 or the local emergency number right away. The operator who answers will give you further advice about what to do.
Do not smoke, eat, or drink for 5 to 10 minutes after taking nitroglycerin. If you do smoke, you should try to quit. Your provider can help.
When To Go To The Doctor
You cant always assume the discomfort is no big deal. If pain lingers for more than a few days or requires regular pain medications, you should be evaluated by your physician, says Leda Ghannad, MD, assistant professor of orthopedic surgery and physical medicine and rehabilitation at Rush University Medical Center. Another sign: if the pain limits your abilities in your day-to-day life, like you have to call off work to stay in bed. Following are signs you need to get medical help, pronto.
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How Do Doctors Diagnose The Cause Of Upper Back And Chest Pain
Your doctor may look for heart problems first. Diagnostic tests they may order include:
- chest X-rays to look at the structures in your chest
- ECG to look at your hearts rhythm
- cardiac ultrasound to view your heart as it beats
- angiogram to look at the blood flow in your heart
- cardiac catheterization to look for any blockages in your blood vessels
- stress test to see how your heart functions when stressed
- blood tests to check for specific enzymes that may indicate heart damage
If the tests dont indicate a heart condition or if you have any other symptoms, your doctor will look for other possible causes. Other tests they may order include:
What Back Pain Treatment Options Are Available To Me Back Pain Radiating To Chest And Head
There are many methods for treating back pain at home, but only a few of these have been proven to be effective. The most common treatment is rest and applying ice to the painful area. This treatment is very relaxing and should be used for only 10-20 minutes. It should never be applied while you sleep. Also, exercise and stretching exercises are essential for keeping muscles and supporting tissues flexible. While some of these methods may not seem like they are effective for you, they can help you overcome your back pain.
Physical therapy is a good option for treating back pain. It will help you improve your posture and strengthen your core muscles. Massage therapy and acupuncture are other options for relieving tension and reducing joint pain. Some people also find that water therapy improves flexibility and balance, while yoga helps them heal faster from injuries. Proper nutrition and lifestyle changes are also important for treating back pain. It is very important to consult a physician if you are experiencing back pain because it will help you avoid more serious conditions later on.
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Development Of Upper Back And Chest Pain
The chest and upper back are in close proximity to each other with both sharing many ribs that help protect the same vital internal organs. Some of the underlying biomechanics that can contribute to both upper back and chest pain include:
- Muscle dysfunction. Muscle inflammation or strain in the chest and/or upper back region can cause muscle tightness and/or spasms. When one muscle becomes painful or stiff, other nearby muscles may also become painful in response, such as if they need to work harder. Additionally, tendons, ligaments, or the muscleâs connective tissues may become overstretched or inflamed and refer pain to the chest and upper back.
- Problem with internal organs. Various problems or conditions can develop in the heart or lungs, which may send pain to both the chest and upper back.
Many other factors may be involved with developing chest and upper back pain. Sometimes upper back and chest pain may also have more than one cause or separate causes.
How Do I Know If My Chest Pain Is Serious
You may not be able to tell the difference between a heart attack and noncardiac chest pain. For this reason, you should always take chest pain seriously. If it is sudden or new and lasts longer than five minutes, go to the emergency room. If it goes away after a few minutes, it may not be an emergency, but you should still see your healthcare provider as soon as possible to determine the cause. Noncardiac chest pain, whatever the cause, can always occur again, and can end up affecting your quality of life.
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Ongoing Abdominal Pain Chest Pain And Back Pain
I am 40 year male and have multiple health issues happening to me now, but in the beginning of my discussion I will mainly focus on explainning abdominal pain and chest pain then I will mention about back and joints pain.
Around late July, middle of night, I had discomfort around where gallbladder is located.
The following week, the discomfort turned into minor but clearly noticeable pain and I thought my liver was failing. I also had multiple nauseas at that time.
A week later, around 2 am, I had chest pain radiating from center of my chest, so I rushed to E.R.The E.R doctor told me my chest was fine after checking EKG and other things.He also told me my liver was fine after running blood test.He advise me to see my primary physician for getting ultra sound imaging for my gallbladder although the blood test did not show inflamed gallbladder issue.
Few days after that, I went to see my physician, but he refused to get me ultra sound imaging for gallbladder because I had it last year and the test came out normal for both of my gallbladder and liver. I also finished Hep B vaccine January this year.
He then had me do stool sample because I had H.pylori last year and treated for it but they never checked to see if I was clear of H.pylori after the treatment.The stool sample test returned and I was told that I was clear of H.pylori.
I began taking Omeprazole and I had been on it for 3 months.
I quit drinking alcohol 7 years ago and do not smoke