Overview
The cervical spine is more commonly known as the neck region, beginning at the base of the skull and connecting to the thoracic region of the spine.
It consists of the C1-C7 cervical vertebrae, and it includes the surrounding nerves, muscles, ligaments, and tendons. The first cervical vertebrae is known as the atlas and is different from the next six because it is ring-shaped. It rotates on the second vertebrae, the axis, allowing it to have a 180° rotation movement. Another commonly used name for upper (cervical) back pain is Cervicalgia.
The Thoracic Spine and Upper Back Pain
There are various ways upper back pain can manifest, including aching pains in the neck or shoulder, throbbing, or sharp pain in the thoracic region of your back. The thoracic spinal region consists of the upper and middle back, starting at the base of your neck (around C7) and extending below the ribcage, ending right above the first vertebra of your lumbar spine (L1).
Thoracic vertebrae are labeled T1 through T12. Nerves in these vertebrae extend into the chest, arms, and hands. T3 through T5 nerves extend into the chest wall and help control breathing. Vertebrae T6 through T12 affect the abdominal and back muscles, aiding balance and posture and assisting coughing.
When nerves become compressed in the cervical or thoracic spine, patients commonly experience the symptoms of upper back pain. Muscle irritation, ligament injuries, and overuse injuries can also contribute to painful symptoms.
Causes of Upper Back Pain
There are various potential causes of upper back pain, including natural aging, poor posture, and injuries. Furthermore, certain conditions, such as arthritis, cervical disc degeneration, and spinal cord compression, can also contribute to pain. In rare cases, cancer or meningitis may cause upper back pain.
Treatment Options
Treatment Options May Include:
- Acupuncture
- Anti-inflammatory medications
- Artificial disc replacement
- Cervical fusion
- Pain medications
- Physical or Chiropractic Therapy
- Steroid Injections
- Surgery (discectomy)
- Therapeutic Message
- Medial Branch Blocks
- Medial Branch Radiofrequency Ablation
Symptoms
Symptoms include:
- Decreasing muscle tone in the arms and/or hands
- Decreasing dexterity of the hands
- Muscle spasms in the legs
- Numbness and or weakness in the upper extremities
- Severe headaches
- Sharp neck or arm pain
- Shooting pain or tingling in the arms and/or hands
- Stiff neck
When To See a Doctor
If your back pain comes on suddenly, is the result of an injury, or causes intense pain or mobility issues, see a doctor as soon as possible. If the pain comes and goes or persists for two weeks without improvement, it is also a good idea to speak with a medical professional.
Whenever back pain interferes with your normal activities, you need the support of a spinal expert to identify the underlying cause and find the best treatment.
You should never live in pain or accept that back pain is just a part of life. When new symptoms emerge or intensify, seek medical attention.
Diagnosis/Tests
Your doctor can perform numerous tests to diagnose the source of your upper back pain. These include:
- Bone scan
- CAT scan
- Electromyogram and Nerve Conduction Studies (EMG/NCS)
- Medical history (helps assess severity in condition of pain)
- MRI
- Myelogram
- Neurological exam
- Physical examination
Each type of diagnostic procedure is designed to highlight the root cause of your symptoms while helping the doctor pinpoint the key source of pain. Once they know which part of your spine is contributing to your symptoms, they can develop personalized care plans that bring you relief.
Types
Some spinal conditions can lead to upper back pain, including:
- Cervical Spondylosis (Arthritis of the Neck)
- Cervical degenerative disc disease
- Cervical Stenosis
- Fractures
- Herniated disc
- Spinal alignment
Causes
Causes & Contributing Factors May Include:
- Aging
- Arthritis
- Cervical disc degeneration
- Cancer or Meningitis (rare)
- Injuries
- Poor posture
- Spinal cord compression
- Stress from bending, twisting, turning, or lifting
Facts
- Most people (nearly 2/3) will experience some kind of neck pain during their lifetime.
- Although very rare, cervical back pain can be a sign of infection, cancer, disease, injury, or blood vessel issue.
- A stiff neck is rarely serious and will usually fade or disappear without treatment.
- Neck pain is usually unexplained, with pain sometimes lingering and sometimes quickly disappearing.
- Neck pain accompanied by no other obvious problems is usually temporary and minor.
