A Brief Explanation Of Upper Back Anatomy And Causes Of Back Pain
The thoracic spine, which is also called the upper back or middle back, is very different in form and function to the cervical spine (the neck) or the lumbar spine (the lower back). We obtain mobility from the neck and lower back but the thoracic spine is designed to be extremely stable and strong to allow us to stand upright, it also protects vital organs such as the heart and lungs.
As this part of the spinal column has a great deal of stability and very limited mobility, there is generally very little risk of degeneration or injury in the upper back over time. By far the most common causes of this type of pain are joint dysfunction and muscular irritation. There may have been an injury to a disc in the upper back such as a thoracic herniated disc or degenerated disc that causes such related back pain, but these injuries are very rare.
The word “thoracic” means relating to the chest, and the thoracic spine is the section of the spine that corresponds to the chest area consisting of:
– Twelve vertebrae in the centre of the spine with ribs attached make up the thoracic spine. If viewed from the side, this section of the spine is slightly concave.
– Each vertebra in the thoracic spine is connected to a rib on both sides at every level and these in turn meet in the front and attach to the sternum which is also known as the breastbone. This creates a cage (the thoracic cage) that provides structural protection for the vital organs of the lungs, heart and liver, and also creates a cavity for the lungs to expand and contract.
– The upper nine ribs begin at the spine, curve around and are joined at the front of the chest. Because the ribs are firmly attached at the back (the spine) and the front (the sternum), they allow for very limited movement in the spine.
– The lower three ribs do not join together at the front, but do function to protect the vital organs while allowing for slightly more movement.
– The joints between the bottom thoracic vertebra (known as T12) and the top lumber vertebra (L1 in the lower back) allow twisting movement from side to side.
Because there is very little mobility and a great deal of stability throughout the thoracic spine, this part of the back does not usually tend to develop common spinal disorders such as degenerative disc disease, herniated disc, spinal stenosis, or spinal instability. These disorders can cause long-term back pain but they are quite rare in the upper back.
Because of this stability and lack of mobility, in most cases anatomic causes of upper back pain cannot be found. An MRI scan or CT scan will rarely image an anatomic problem that is amenable to any sort of surgical solution for the upper back pain. Main causes therefore seem mostly to be either joint dysfunction or muscular irritation and any related treatment will need to be based on this diagnosis.
Jan Griffiths has extensively researched upper back pain relief and writes for a good many internet resources to assist sufferers as well as maintaining her own back pain blog.