Thoracic Back Pain is most
Commonly Muscle Pain

Thoracic back pain is often related to the muscles. 

Upper back pain is often related to the many layers of muscle that run in different directions across your upper back. Other possible causes of upper back pain are vertebral compression fractures, and shingles.






Upper back muscle pain may be related to some type of repetitive motion or overuse disorder. Another common possibility is Myofascial Pain Syndrome or Myofasciitis. 

Muscle Pain from Overuse

This is most commonly acute thoracic back pain that occurs when active people do things that their body is not accustomed to doing.

This type of thoracic back pain can occur after a weekend of working in the garden or after a Saturday football game.

Acute Pain

When you put your muscles through vigorous activities that they have not been conditioned to perform you can expect some muscle pain.

This can also happen when you start a new job or change professions. When you suddenly start some type of bending or twisting motion that you constantly repeat throughout the day your muscles may become inflamed and painful until they become accustomed to these new activities. 

man in pain

It will get Better

This is not a common cause of chronic thoracic back pain but it can occur repeatedly when you repeatedly do things that you are not used to.

Overuse muscle pain will generally resolve with a few days of limited activity and over the counter pain medications such as ibuprofen or naproxen.

Myofascial Pain Syndrome

This type of thoracic back pain that is coming from the muscles in your upper back. This can cause pain that is only mild and annoying or it may cause pain that is sharp and stabbing.

Myofascial Pain Syndrome is thought to be caused by some type of constriction between the muscle and the fascia that surrounds it. 

The Anatomy of a Muscle 

Every muscle in your body is surrounded by a layer of connective tissue called the fascia. This fascia acts like a container for your muscle. It allows your muscle to expand and contract inside of the fascia, and it allows different muscle groups to slide over the top of each other as you reach and move or twist.

Your upper back as many layers of muscle and many different muscle groups. Each one is contained within its own fascia. Normally all of these muscles slide back and forth over the top of each other as well as expand and contract within their fascia.

Possible Causes of Myofascial Pain

Myofascial pain can occur when these muscles fail to slide smoothly. It is not well understood what causes this problem but some of the possibilities include:

     Scar tissue from minor trauma

     Adhesions from lack of activity

     Muscle spasms

     Repetitive motion

     Stress induced muscle tension

     Some Combination or All of the above

Symptoms of
Myofascial Pain 

The common symptom of Myofascial Pain  is pain.

The pain can be variable and may be mild or severe.

The pain is usually located in one specific spot; most often in the middle or belly of a muscle.

This depiction of a myofascial trigger point complex shows and swelling and inflammation within the muscle fibers.

Image thanks to David Parmenter, via Wikimedia Commons

A Tender Knot

There may be tightness along the muscle or a tender knot within the muscle.

These tender spots are known as trigger points and this may be where the pain is centered. 

Stretching the Muscle may Cause Increased Pain

Commonly the pain is described as deep and aching. It is often worse with reaching or other motions that stretch the muscle group where the pain is located.

This type of muscle pain can become chronic with episodes that flare up periodically over long periods of time. 

Thoracic Back Pain Ch2
Treatments for Myofascial Pain



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