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31 years
I'm experiencing a middle to upper back pain, it suddenly started & with certain movements it gets so strong that I have difficulty breathing, even at rest it hurts. What is it and what should I do?
Aug 28, 2014
2nd opinion

Dr. Zakia Dimassi Pediatrics
Upper or middle back pain can occur anywhere from the base of the neck to the bottom of the rib cage. This area is known as the thoracic spine.
Although upper back pain is not so common, it can be a source of significant discomfort and pain when it does occur. It often causes a dull, burning, or sharp pain. Your muscles may also be tight or stiff. The most common causes of upper back pain are muscular irritation (myofascial pain) and joint dysfunction.
An injury affecting one or more discs in the upper back (such as a thoracic herniated disc or degenerated disc),a rare instance, causes upper back pain.
Upper back pain can occur as a result of trauma or sudden injury, or it can occur through strain or poor posture over time. This latter complaint has grown familiar in recent years among people who work at computers most of the day. Often, upper back pain occurs along with neck pain and/or shoulder pain.
Muscular Irritation
The shoulder girdle attaches by large muscles to the scapula (the shoulder blade) and the back of the thoracic rib cage. These large upper back muscles are predisposed to develop irritation (myofascial pain) that can be painful and difficult to relieve. More often than not, muscular irritation and upper back pain is due to either de-conditioning (lack of strength) or overuse injuries (such as repetitive motions). Muscle strains, sports injuries, auto accidents, or other injuries can all result in pain from muscular irritation.
Pain medication and physiotherapy, in addition to avoidance of the injuring factors, are the mainstay of treatment.
Joint Dysfunction
The ribs connect with the vertebrae in the thoracic spine by two joints that connect with each side of the spine. Dysfunction in these joints can result in upper back pain.
Treatment for this type of injury usually includes manual manipulation to help mobilize the joint, with subsequent home exercise program for stretching the spine and shoulders as well as strengthening. Aerobic conditioning is also very important to maintain sustained upper back pain relief.
Pain medications are also useful, anti-inflammatory medications (such as ibuprofen or COX-2 inhibitors), are the most effective in this case.
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