back pain

WHAT CAUSE UPPER AND MIDDLE BACK PAIN? HOW TO TREAT MILD UPPER AND MIDDLE BACK PAIN?

WHAT CAUSE UPPER AND MIDDLE BACK PAIN?

Upper and middle back pain may be caused by:

  • Overuse of, or injury to, the muscles, ligaments and discs that make up the thoracic spine.
  • Poor posture. Slumping or slouching when you sit or stand, especially when using a computer for a long time.
  • Pressure on the spinal nerves from problems such as a herniated disc.
  • Osteoarthritis from the breakdown of the protective cartilage that cushions your facet joints in the spine.
  • A fracture of one of the vertebrae.

HOW TO TREAT MILD UPPER AND MIDDLE BACK PAIN?

(1) Exercises and stretches
Stretching and an active lifestyle help reduce back pain and speed the recovery process following an injury.

As upper back pain is related to large muscles in the shoulder area, exercise to stretch and strengthen the muscles of your back, shoulders, and stomach are largely recommended. These muscles help support your spine. Exercise will also strengthen the muscle groups that support your mid-back to help relieve back muscle pain. Both specific exercises and stretches for this region together with general exercise, such as swimming, walking, cycling, are recommended.

Regular yoga or Pilates sessions can also help relieve back muscle pain as they incorporate a number of positions and moves that use the upper and middle back muscles.

(2) Manual therapy and physical therapy
Manual therapy includes massage or spinal manipulation. It helps reduce muscle tension and pain in the back and improve blood flow.

(3) Practice good posture

Poor posture puts stress on your back and can cause upper and middle back pain. Try to stand or sit tall, keeping your back as straight as possible and balance your weight evenly on both feet. Don’t slump or slouch. When sitting, keep your shoulders rolled back and be sure to adopt suitable positions when using computers and driving. If you spend a lot of time at a computer, at home and work, make sure the screen is at eye level, never below and not too far away so that you have to reach to it. If you spend a long time in the car raise the steering wheel and sit closer to it. https://www.nhs.uk/conditions/back-pain/

back pain

BACK PAIN

Pain affecting the back often restrict movement. The pain usually lasts for only a week or so but can recur in some people.

Back pain is usually caused by minor damage to the ligaments and muscles in the back because muscles and ligaments supports most of the body’s weight from movements such as bending, twisting and stretching. Less commonly, lower back pain may result from an underlying disorder such as prolapsed intervertebral disc in the spine.

Investigations for back pain, such as x-rays, CT scan or MRI sometimes reveal abnormalities such as disc prolapse that may require surgical treatment.

In most cases, back pain can be treated with over-the-counter painkillers, nonsteroidal anti-inflammatory drugs or muscle-relaxant drugs. Other treatments include acupuncture, spinal injection, exercise or spinal manipulation. https://www.nhs.uk/conditions/back-pain/

back pain

COMFORTABLE POSITIONS WHEN YOU SUFFER FROM BACK PAIN

Below are some of the positions that help ease back pain:

  • Lie on your back with a pillow or two under your knees.
  • Lie flat on your front. If this position is too painful, try again with one or two pillows under your hips. As your pain eases, remove the pillows so that you are completely flat.
  • Lie on your side with a pillow between your knees. Sometimes a rolled-up towel around your waist also helps.
  • Sitting is often very uncomfortable so it is best to only sit for short periods. If you have to sit it may help to sit on an upright chair with a small rolled towel placed between your lower back and the chair. https://www.nhs.uk/conditions/back-pain/
back pain

Treatments for back pain from a specialist

Extra treatment from the specialist may be recommended if self-help measures alone do not improve the back pain.

These extra treatments include:

  • group exercise classes where you’re taught exercises to strengthen your muscles and improve your posture,
  • manual therapy treatments, such as manipulating the spine and massage, which are usually done by a physiotherapist, chiropractor, osteopathy,
  • psychological support, such as cognitive behavioural therapy (CBT) if you are struggling to cope with pain.

Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition. https://www.nhs.uk/conditions/back-pain/treatment/

back pain

WHAT CAUSE MUSCLE SPASM ON THE BACK?

In general, most back muscle spasms occur because of the following reasons:

(1) The muscles are trying to protect themselves from muscle strain

A back spasm can occur after any type of strain or injury to the soft tissues (muscles, tendons or ligaments) in the spine. This type of soft tissue injury typically heals enough within a week or two for the muscle spasms to stop.

(2) The muscles can spasm in response to an underlying anatomical problem

If your back spasm does not get better in 1 to 2 weeks, or it comes and goes overtime in the same area of your back, you may have an underlying anatomical problem in your spine. Some examples of underlying issues that could cause your back to spasm include:

  • Facet joint osteoarthritis
  • Spinal stenosis
  • Degenerative disc disease
  • Herniated disc

When these or other underlying anatomical problems are present in the spine, muscle spasms are likely to keep recurring due to ongoing inflammation or instability. It is important to seek medical attention to treat the underlying cause of your symptoms, rather than just treating the symptoms. https://www.nhs.uk/conditions/back-pain/

back pain

COMMON CAUSES OF BACK PAIN AND NECK PAIN

Common causes of back pain and neck pain can be divided into acute common causes and chronic common causes.

ACUTE COMMON CAUSES OF BACK AND NECK PAIN

The most common cause of acute back or neck pain is a muscle injury, in which muscle fibres stretch too far and tear. Muscle injury may be caused by overuse, such as from heavy lifting, as well as by repetitive motions that put continual stress on the back or neck muscles.

Most muscle injuries alleviate within 6 weeks using treatments such as over-the-counter pain medicines, heat or ice therapy, or stretching exercises.

CHRONIC COMMON CAUSES OF BACK AND NECK PAIN

  • Lumbar disc herniation. A herniated disc occurs when the soft, gel-like interior of the disc bulges or leaks outward, irritating nearby muscles, joints, or nerve roots. A herniated disc typically causes sharp, stabbing pain down to the back of the legs (sciatica), which is usually more pronounced than low back pain.
  • Lumbar degenerative disc disease. Wear-and-tear on the spinal discs that cause chronic low back pain is called lumbar degenerative disc disease. This condition typically causes chronic, low-level low back pain that intermittently flares up for a few days or weeks before returning to normal.
  • Osteoarthritis. Spinal osteoarthritis consists of wear-and-tear on the facet joints, causing excess friction when twisting or bending the spine. This friction can lead to bone spurs that pinch a nerve root and produce sciatica pain. Other symptoms include stiffness and tenderness around the joint.
  • Sacroiliac joint dysfunction. The sacroiliac joint connects the hip bones (the ilia) to the sacrum, a triangular bone at the base of the spine. When the sacroiliac joint experiences too much or too little motion, it may cause pain in the hips, pelvis, and lower back.
  • Spinal stenosis. Narrowing of the spinal canal due to a bone spur, herniated disc, or another irritant can cause leg pain (sciatica). While back pain may occur with spinal stenosis, it is usually not as severe as the leg pain caused by nerve root irritation.
  • Isthmic spondylolisthesis. A spinal condition occurs when one vertebral body slips forward over the vertebra below it, straining the disc and joints at the spinal segment. Slippage is caused by a fracture in the back of the vertebrae. Low back pain, stiffness, and leg pain, numbness, and/or weakness are common symptoms of Isthmic spondylolisthesis. https://www.nhs.uk/conditions/back-pain/causes/
back pain

UPPER CROSS AND LOWER CROSS SYNDROME

Upper cross syndrome and lower cross syndrome are terms referring to muscle weakness and tightness in certain areas of the body that may be contributing to pain and/or reduced functional level. Each “syndrome” entails two predominant areas of muscle tightness and two predominant areas of muscle weakness. Oftentimes, these limitations occur as a result of impaired posture and can lead to pain. Once identified, both upper cross and lower cross syndromes can be effectively treated and managed with physical therapy care.

UPPER CROSS SYNDROME

The upper cross syndrome refers to the “upper half” of the body; the waist up. The two zones of muscle tightness are the pectoralis (pec) muscles and the upper trapezius/levator scapulae muscles. The pec muscles (pec major and minor) are located on the anterior (front) aspect of the chest. The upper trapezius and levator scapulae muscles are both located on the lateral (side) aspect of the neck and connect into the back. At the end of a long workday at a desk, posture can become less than ideal which includes forward head posture and slouching of the shoulders. With poor posture, these muscles become stretched and are unable to perform their jobs as effectively as needed and can lead to pain.

LOWER CROSS SYNDROME

The lower cross syndrome refers to the “lower half” of the body; the waist down. The two zones of muscle tightness are the lumbar (low back) paraspinal and the hip flexor muscles. The lumbar paraspinal is located in the lower back on either side of the spine. The hip flexor muscles are located on the front of each hip. Standing posture contributes to the prominence of the lower cross syndrome and includes increased curvature through the lower back and positioning of the abdomen in a more anterior (forward) position. Over time, standing with increased curvature through the lower back and can lead to increased tightness through the lumbar paraspinal and hip flexor muscles. These limitations form half of the “cross” of the lower cross syndrome. The second portion of the cross of lower cross syndrome involves weakness through the gluteal and abdominal muscles. With poor standing posture, these muscles become stretched and are unable to perform their jobs as effectively as needed and can lead to pain. https://www.nhs.uk/live-well/exercise/common-posture-mistakes-and-fixes/

back pain, Facet joint radiofrequency denervation, neck pain

FACET JOINT RADIOFREQUENCY DENERVATION FOR NECK PAIN AND BACK PAIN

FACET JOINT

The spine is a column of bones arranged one on top of the other. The bones are linked at the back by joints called facet joints, one on each side. The facet joints hold the bones together and stabilise the spine, while also allowing movement.

The facet joints may become painful either due to wear and tear (also called degenerative change), stress or injury, although the reason is not always clear. Pain is felt around the facet joints and in the surrounding area. For example, pain starting from the joints of the lower back will often be felt in the buttocks and upper legs.

WHEN IS DENERVATION USED?

The denervation procedure is usually considered after trying less invasive treatments, such as medication, physiotherapy, transcutaneous nerve stimulation (TENS).

Exercise, acupuncture, yoga/pilates and relaxation therapy may also help ease back pain. Spine surgery could be also considered in selected cases.

Denervation is usually only considered if you have responded well to local anaesthetic injections near the affected areas, and these have helped to reduce pain.

WHAT IS THE FACET JOINT RADIOFREQUENCY DENERVATION

Facet joint radiofrequency denervation is a procedure in which nerve fibres supplying the painful facet joints are selectively destroyed by heat produced by radio waves and delivered through a needle.

The treatment is usually performed after an injection of a local anaesthetic close to the affected joints has helped to reduce feeling and pain.

The denervation treatment involves placing a special needle (radiofrequency probe) near the nerve of the joint; when a radiofrequency current is passed down the probe, a very small area of heat is created that causes a break in the nerve. This procedure does not affect any other part of the body. https://www.nice.org.uk/researchrecommendation/radiofrequency-denervation-what-is-the-clinical-and-cost-effectiveness-of-radiofrequency-denervation-for-chronic-low-back-pain-in-the-long-term