Upper back pain
Upper back pain is pain in the area between the lower neck and lower back, often around or between shoulder blades. The pain can be felt on one side or over a larger part of the upper back. Sometimes the complaint occurs suddenly after a wrong movement, injury or intensive load, but often it develops gradually.
Long-term sitting, screen work, repeated movements and muscle tension can play a role. The pain can be nagging, pressing or sharp and associated with stiffness or strained muscles. Sometimes movements of the neck, shoulders or torso are painful.
Acupuncture and Chinese herbal medicine can be used to reduce pain and muscle tension and support recovery. It looks at the place and character of the pain, how the complaint arose and what factors they influence.
Western disorders in which upper back pain may occur
Upper back pain is a symptom and can have several causes. Often these are symptoms from muscles, joints or other structures of the upper back. Possible causes and diagnoses are:
- muscle and myofascial pain;
- muscle and other tissue overload;
- complaints of the vertebral column or rib joints;
- osteoarthritis and other age-related changes in the spine;
- an intermediate vertebral disc problem in the sternum column;
- complaints after a fall, accident or sports injury;
- pain radiating from the neck to the upper back or shoulder blades.
A specific condition does not always need to be identified. Upper back pain is common without any apparent damage or deviation explaining the symptoms completely.
Possible causes
A common cause of upper back pain is prolonged or repeated stress. Think of sitting long, VDU work, working much in the same position or exercising where muscles around the shoulder blades and sternum column are intensively loaded.
Sudden movement, fall, collision or other trauma can also cause symptoms. Tension and stress can contribute if the muscles around the neck, shoulders and upper back remain stretched for a long time.
In the case of persistent complaints, reduced mobility of the vertebral column, insufficient muscle strength or previous injury may also play a role.
How can acupuncture help with upper back pain?
Acupuncture looks at the location of the pain, the character of the symptoms and what movements or circumstances affect. Muscle tension, stiffness, possible radiant pain and the duration of the complaints are also included.
Acupuncture may include:
- reduce upper back pain and tenderness;
- reduce tension in the muscles around the spine and shoulder blades;
- reduce stiffness and support upper back movement;
- support the recovery after overload or injury;
- treat stress when stress clearly affects the complaints;
- support prolonged or recurrent upper back complaints.
Depending on the cause, acupuncture can be combined with physiotherapy, exercise therapy, massage or targeted strength and mobility exercises.
How can Chinese herbal medicine help with upper back pain?
Chinese herbs can be used in addition to acupuncture, especially when upper back pain is present for a long time, regularly returns or is part of a broader grievance image. Herbs can be used daily between treatments.
Depending on the underlying pattern, Chinese herbal medicine may focus on:
- support local flow in the event of sharp, local or persistent pain;
- treat pain and stiffness when cold or damp weather worsens the symptoms;
- regulate tension when stress and tense neck, shoulder and back muscles play a clear role;
- Support the recovery where complaints persist after an injury;
- support general capacity for activity when fatigue and slow recovery are associated with pain.
Herbs are not needed for every type of upper back pain. In the case of mainly local complaints, the emphasis may be on acupuncture, movement and tackling factors that continue to burden the upper back.
How does Chinese medicine view upper back pain?
Within Western medicine, among other things, we look at muscles, joints, vertebrae, nerves and other structures that can cause the pain. Traditional Chinese medicine (TCM) also looks at the character of the pain and at circumstances that cause or persist in the symptoms.
In upper back pain, the meridians and the flow of Qi and Blood are particularly central. Meridians within TCM are seen as compounds through the body that circulates Qi and Blood. Several meridians run across the upper back and around the shoulder blades. Therefore, the precise location of the pain can help determine which areas receive attention during treatment.
An important starting point within TCM is that pain occurs when free flow is hindered. Overload and prolonged muscle tension can cause relatively mild stagnation. After a fall, collision or other injury local stagnation can be stronger. Cold and moisture can also contribute to pain and stiffness according to TCM.
For upper back pain, the influence of tension and emotions may also be relevant. For example, if symptoms increase significantly during periods of stress and when combined with tense neck and shoulder muscles, it will look at whether Qi's free movement is affected by this.
In the case of long-term or recurring complaints, general capacity for activity is also considered. If the pain occurs mainly with fatigue and improves by rest, TCM believes that an underlying deficiency can contribute to maintaining the complaints.
A recognizable combination of such characteristics is called a TCM pattern. Several people with pain between the shoulder blades can get different treatment.
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns may occur at the same time. Not everyone with the same pattern has all the mentioned symptoms. The pattern is determined based on the overall picture of your symptoms.
What's a meridian?
Most common TCM patterns for upper back pain
Qi- and Blood stagnation
With Qi- and Blood stagnation, the local flow in the upper back is impaired. This can be caused by prolonged loads, repeated movements or strained muscles.
Common symptoms: nagging, oppressive or pulling pain, tension around the shoulder blades, stiffness and pain affected by certain postures or movements. Moving, heat or massage can sometimes give relief.
Examples of Western disorders: myofascial pain, muscle-related upper back pain and overload symptoms.
Blood stasis
At Blood stasis, local stagnation is stronger and more persistent. This pattern can occur after a fall, collision, whiplash or other injury, but also when local pain persists for a long time.
Common symptoms: sharp or stabbing pain, clearly defined pain spot, strong sensitivity to pressure and pain that may also be present at rest. The symptoms can become clearer at night.
Examples of western disorders: upper back pain after an accident or sports injury and prolonged local pain after previous injury.
Wind-Cold-Dampness
According to TCM, cold and moisture can hinder free movement in muscles and joints. This pattern fits especially when temperature and weather conditions clearly affect the upper back.
Common symptoms: pain and stiffness, feeling cold or heavy in the upper back, worsening in cold or humid weather and improvement by heat and quiet movement.
Examples of Western disorders: prolonged muscle and joint discomfort and osteoarthritis in which cold and stiffness play a clear role.
Liver Qi-stagnation
With Liver Qi-stagnation, the movement of Qi according to TCM is less flexible. In upper back pain this is especially relevant when stress or emotional tension clearly coincides with muscle tension.
Common symptoms: tense neck, shoulder and upper back muscles, oppressive or twitching pain, varying symptoms and worsening during periods of stress. Headache, jaw tension, irritability or restless sleep may occur simultaneously.
Examples of Western disorders: non-specific upper back pain and myofascial neck, shoulder and upper back complaints in which tension plays a clear role.
Qi- and Blood deficiency
In case of long-term or recurrent complaints, TCM says that insufficient Qi and Blood can contribute to reduced nutrition and capacity for activity of muscles and other tissues. The pain is then less isolated and usually associated with general symptoms.
Common symptoms: whining or recurrent upper back pain that gets worse with tiredness or prolonged stress, improvement due to rest, fatigue, muscle weakness and reduced recovery ability.
Examples of Western disorders: long-term non-specific upper back pain and recurrent muscle complaints with fatigue and reduced capacity for activity at the forefront.
Outlook
How quickly upper back pain improves depends on the cause, duration and severity of the complaints and factors that continue to burden the upper back. Acute muscle or overload symptoms can recover relatively quickly. Long-term complaints, complaints after an accident or problems in which stress, posture and muscle tension continue to play an important role usually require more time.
In the initial phase, treatment is often given approximately once a week. For acute or severe symptoms, temporary treatment can be appropriate two to three times a week. When pain and stiffness decrease, the frequency can usually be reduced. These are guidelines; the course of treatment is tailored to your situation.
In the case of recurrent complaints, it is important to include factors such as movement, strength, work posture and daily stress.
When is medical research important?
Upper back pain often occurs from muscles or joints, but pain in this area can sometimes come from structures outside the back. Therefore, it is important not to assume only a muscle or back problem in certain complaints.
Seek immediate medical attention in case of sudden upper back pain combined with chest pain or pressure, breathlessness, sweating, nausea, fainting or pain radiating to arm, jaw or back.
Medical assessment is also important in case of severe pain after an accident, increased loss of strength or sensory impairment, fever or severe illness, unexplained weight loss or new severe pain not affected by posture or movement.
Even if upper back pain persists or clearly worsens without known cause, it is wise to have the cause assessed.
Contact
Do you suffer from upper back pain and want to know if acupuncture can help you?
During a first consultation, we will discuss your symptoms, medical history and factors that may affect the pain. On this basis, a treatment plan will be drawn up to match your situation.
You can make an appointment directly online or contact us for more information.