Causes of upper back pain range from poor posture and sitting for prolonged periods of time to degenerative diseases or traumatic injuries. Treating the underlying condition is paramount to a successful exercise rehabilitation program. Your doctor can provide an accurate diagnosis with a treatment plan followed by a physical therapy or home-exercise routine.
Physiology of the Upper Back
Upper back pain is not always directly attributable to a condition specified at the location of the pain. The spinal column starts at the base of the skull and extends down into the sacral region of the lower back at the buttocks. It is comprised of joints, ligaments and muscles working together to support your body when walking, standing, sitting or performing any activity. In the upper back, the spinal column works with the shoulder girdle, the abdominal muscles and chest muscles to support and balance the spine. An imbalance somewhere other than the upper back may be causing your upper back pain.
Causes of Pain
According to J. Talbot Sellers, D.O., of Spine-Health, most upper back pain results from either muscular irritation, joint dysfunction or a combination of both. Muscular irritation stems from over-use injuries, an imbalance in chest and back muscle strength or fatigue. Joint dysfunction refers to problems such a stenosis or bone spurs, arthritis or herniated inter-vertebral discs impairing nerve function. The course of rehabilitation is determined by the cause of injury and severity.
Your condition may require surgery to first treat the underlying condition such as removing bone spurs, replacing herniated discs or opening nerve channels to reduce nerve compression. Other conditions such as muscle strains require rest and anti-inflammatory medications to first treat the problem.
Developing an Exercise Routine
Once the underlying condition is effectively treated, a rehabilitation program can be established to maintain or increase mobility and strengthen the upper back and weak muscle groups to prevent future relapse. One of the first parts of rehabilitation is stretching your muscles and ligaments. Starting from the top and working your way down, do neck rotations with flexion and extension stretches.. Shoulder circles open up the middle back. Building strength is incorporated into the same stretching movements by adding hand resistance when performing flexion or extension exercises. These help focus on the small muscle groups in the neck and back. Rowing, bench presses, dumbbell flyes and push-ups build the large muscles groups in the upper back.
Monitoring Progress
It is important to start slow and build stamina over time without expecting immediate results according to Peter F. Ullrich, Jr., M.D., of Spine-Health. Your doctor, physical therapist and you should work together to set realistic and achievable short-term, weekly goals. You may only be able to turn your head 20 degrees to the right when you first start. Striving to get to 25 degrees is a better goal for the first week compared to trying to get to 90 degrees. Evaluate and adjust goals based on performance success.
Considerations
If you are recovering from a serious upper back injury or condition, refrain from high-impact sports and exercises such as running, contact sports or other activities with a high amount of jumping or jarring. Swimming, walking and cycling do not add strain to the back and are less compressing to the spine than high-impact activities. Find an aerobic activity to help build stamina and condition muscles without creating further upper back pain.
