Upper Back / Chest

Upper Back Pain in Degenerative Diseases

What is upper back pain as a result of degenerative disease?

Upper back pain is pain felt in the area of the back from the lower part of the neck down to the waist. If the pain is also felt outside this area, it is referred to as upper back pain with radiation, e.g., forward radiation to the breastbone or the abdomen. Degenerative refers to deterioration of the spinal column as a result of ageing.

Causes

Ageing can cause changes in various parts of the thoracic vertebrae, such as the intervertebral discs, which can become narrower or bulge out, or the small joints (facet joints), which can develop osteoarthritis; however, other structures, such as ligaments and muscles, may also start to function less well as a result of ageing. These changes in the thoracic spinal column as a result of ageing are known as degenerative disease, or simply as 'wear and tear'. It is important to note that in many cases degenerative disease is not necessarily accompanied by pain, rather by stiffness.

Signs and symptoms

The most common symptom caused by osteoarthritis (or arthritis) in the facet joints is pain on one side of the upper back, usually without radiation. The pain often becomes worse after you have been sitting in the same position for a long period of time, or when you turn the upper back and bend backwards.

How is upper back pain diagnosed?

If you have upper back pain, neurological examination is always carried out to exclude the possibility of a disc prolaps of the upper back. In addition to the neurological examination, the movements of the upper back are checked for limitation and pain. The upper back is also examined to feel which vertebrae are painful when pressure is put on them.

Do I need any additional examinations?

  • Diagnostic examination for other non-physical factors important to your pain  already took place  after you filled in your pain questionnaires.
  • If necessary, an upper back X-ray will be carried out  to exclude other possible causes.
  • If another cause is suspected, a chest X-ray or MRI scan will be performed.
  • You will be referred to an internal specialist to exclude any diseases caused by your internal organs.

What are my treatment possibilities?

Multidisciplinary Treatment

Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.

Non-physical Treatments

If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:

Physical Treatments

Medication

Other Treatments

Interventional Pain Treatments