Upper Back (Human Anatomy): Image, Function, Diseases, and Treatments

The upper back is the part of the spine that is located behind the neck, below the cervical spine, and above the lumbar spine, which is located in the lower back. It is the section of the spine that is the most steady.

Due to the fact that it is very rigid and the thoracic spine only has a small range of motion, it is the region of the spine that is the most stable. The thoracic spine is located in the top part of the back.

Because the spine is attached to the ribs, there is a restriction on the amount of mobility that may occur in the upper back. The thoracic spine is made up of a total of 12 vertebrae. The seven vertebrae that make up the cervical spine are located in the neck, whereas the five vertebrae that make up the lumbar spine are located in the low back.

In addition, there is the coccyx and the sacrum, which together consist of five fused vertebrae and the tailbone. The thoracic spine begins at the shoulders and continues all the way down to the waist.

Vertebrae are the building blocks of the spine, and they stack on top of each other in a hierarchy that progresses from the cervical spine to the lumbar spine, with the lumbar spine having the largest vertebrae.

The muscles that are in close proximity to the spine bear a portion of the physical strain. The trapezius muscle, which is situated close to the shoulder blade and aids in both standing upright and throwing an object, Latissimus dorsi is a muscle that aids in arm mobility as well as breathing.

It is placed lower on the lower back. The rhomboid muscle is found in close proximity to the trapezius muscle; it stabilises the shoulders and contributes to the pulling motion. The movement of the body, including the head, neck, shoulders, arms, and legs, is made possible by these muscles.

By cooperating with one another, the muscles in the back make it possible for the body to stretch the back, stoop, twist, and turn the head. These muscles also contribute to sitting and standing in an upright position.

They are a crucial part of the body because they serve to support the spine and facilitate breathing. In addition to shielding the spinal cord and other vital organs, vertebrae play an important role in the body's ability to support its own weight effectively.

• Ankylosing Spondylitis: Over time, this inflammatory condition may cause parts of the vertebrae, the bones that make up the spine, to merge. The spine becomes less flexible as a consequence of this fusing, which may cause a hunched posture. It could be challenging to breathe deeply if your ribs are hurt.
• Osteoporosis: Upper back discomfort may occur as a result of osteoporosis in the thoracic spine. Weakened vertebrae might cause symptoms like sprain, strain, or muscular fatigue because they can't sustain the body's weight as well. As a result, the muscles, ligaments, and tendons must work harder to compensate. These fractures, also known as vertebral compression fractures, are particularly prevalent in the spine. As people become older, both men and women lose bone mass, but postmenopausal women lose it far more quickly and are thus more at risk for osteoporosis.
• Herniated Disc: When the inner gelatinous substance of an intervertebral disc seeps out from the interior of the disc, it may cause a herniated disc in the upper back. In addition to upper back discomfort, a thoracic herniated disc may also result in radiating pain or numbness.
• Spinal Stenosis: A narrowing of the spinal canal is known as spinal stenosis. The spinal cord and the nerves inside the spine may be compressed by spinal stenosis. Usually, the neck and lower back are affected. Wear and tear that comes with ageing is a common cause of the ailment.
• Kyphosis: This is a condition in which the upper back or the spinal region of the back has an excessively rounded spine.
• Cancer: Because of their metastasis (uncontrolled development and spreading) ability, tumours that damage the vertebrae cause cancer in other regions of the body. However, certain tumours, including chordoma, chondrosarcoma, osteosarcoma, plasmacytoma, and Ewing's sarcoma, begin in the bones of the spine.
• Pinched Nerve: This condition happens when the surrounding tissues, such as bones, cartilage, muscles, or tendons, put too much pressure on a nerve. In certain circumstances, bad posture or a sports or weightlifting accident might result in an upper back pinched nerve. An upper back pinched nerve may result in pain, tingling, or numbness both at the injury's location and elsewhere in the upper body.
• Back Muscle Sprains: Back muscles may stretch or tear. Common causes of these injuries include lifting large objects improperly or at all, exercise, overuse, and accidents. Muscle spasms or cramps may result from back strains. Serious injuries may result in paralysis of the back muscles.
• Back Discomfort: Back discomfort persists for an extended period of time is fairly prevalent. Pain may result in stiffness, reduced mobility, and trouble moving. Depression, stress, and worry may also cause tense muscles and back discomfort. Headaches may be caused by pain in the upper back and neck.
• Fractures: In an event, such as a vehicle collision or a tumble, the spine's bones may shatter.
• Osteoarthritis: It is a type of arthritis that occurs when flexible tissue at the ends of bones wears down. The most prevalent kind of arthritis that causes upper back discomfort is osteoarthritis.
• Myofascial Pain: This term describes pain brought on by irritated muscles. It is common for the major upper back muscles to have myofascial pain, which arises from trigger points in the muscular tissue. Weak muscles and repeated actions cause muscular irritability and upper back discomfort.
• Spinal Infections: Infections may be brought on by a bacterial or a fungal infection that has spread from another section of the body via the bloodstream and into the spine. Staphylococcus aureus and Escherichia coli are the two most frequent causes of spinal infections. Painful symptoms are first confined to the infection site. After surgery, SME patients may have symptoms such as wound leakage, redness, edema, or discomfort close to the incision.
• Back Strains and Sprains: These are the most frequent causes of discomfort in the upper back. By lifting anything too heavy or improperly, one risks damaging their muscles, tendons, or ligaments.
• Poor Posture: It may be difficult for many persons with upper back discomfort to stand up straight. That individual could stand 'bent' or 'crooked,' with their torso off to the side rather than straight up and down.
• Problems with the discs: The discs may move or 'bulge' from their place in the spine and irritate a nerve. They may also cause a herniated disc to tear.

• MRI: MRI scans may provide clinicians a picture of both bone issues and soft-tissue damage, unlike X-rays. Herniated discs, as well as issues with the muscles, nerves, ligaments, and more, may be revealed by them.
• CT Scans: An X-ray would have missed any back fractures, but a CT scan may. Soft tissue injuries and blood vessel damage are also easier to observe on CT images. This technique creates cross-sectional slices of the internal organs of the body using X-rays taken at various angles.
• Blood Testing: Blood tests may reveal infections or other anomalies that might indicate illnesses like rheumatoid arthritis or certain forms of malignancy.
• Bone Density Test: A bone density test, sometimes called a DXA test, evaluates the patient's bone mineral density to ascertain if they have osteoporosis or are at risk of developing it.
• Research on Nerves: Muscles react to electrical impulses sent by nerves. This activity is measured by a particular kind of nerve examination called electromyography. It may indicate if a person has spinal stenosis, which is a narrowing of the spinal canal, or a compressed nerve, which may be brought on by a herniated disc.
• Neurological Examination: During a neurological test, a specialist will examine your reflexes, muscle strength, other changes to your nerves, and how your pain spreads—that is, if it leaves your back and spreads to other areas of your body. The neurological examination looks for damage to the spinal nerves.

• Kyphoplasty or vertebroplasty: To repair compression fractures due to osteoporosis, your doctor will inject a glue-like bone cement.Spinal laminectomy/spinal decompression: If you have spinal stenosis (narrowing of the spinal canal), your surgeon may remove bony walls of the vertebrae to ease pressure on the nerves.
• Microdiscectomy: When a disc bulges and presses on a nerve, microdiscectomy – minimally invasive removal of a disc (or portion of a disc)– is the gold standard procedure
• Laminotomy: when there is any sort of disc protrusion, disc bulge or canalicular stenosis in the spine of upper back then then will be done by laminotomy which removes only a portion of the lamina, the back part of a spinal bone
• Hemilaminotomy: when there would be any hemangioma or partial winging or the spine or in the discs of spine of upper back by laminotomy which is a minimally invasive, outpatient surgical procedure performed to widen the spinal canal where it has been narrowed by a thickening of the lamina, the thin bony layer that covers and protects the spinal cord.
• Laminectomy: whenever there is canalicular stenosis of the spine of upper back or disc prolapse of bones of upper back which a surgeon removes part or all of the vertebral bone (lamina). This helps ease pressure on the spinal cord or the nerve roots that may be caused by injury, herniated disk, narrowing of the canal (spinal stenosis), or tumours.
• Milwaukee brace: correction of the disk prolapse or the bending of the spine or any sort of spondylolysis and spondylolisthesis then this device is used The Milwaukee brace is an active corrective spinal orthosis. It consists of a neck ring with a throat mould and two occipital pads to avoid a high pressure in the neck. Other elements are a plastic pelvic girdle, aluminium uprights, leather L-shaped thoracic pads and metal bars in the front and in the back.
• Charleston brace: This brace is worn only at night. Like daytime jacket-style braces, it's a solid piece of plastic that holds the back in position that reduces the scoliotic curvature by holding the patient in a straight position adolescent idiopathic scoliosis.
• Boston brace: The Boston Brace is a plastic body jacket used in the treatment of adolescents with idiopathic scoliosis. The Boston brace, a type of thoraco-lumbo-sacral-orthosis (TLSO), is a back brace used primarily for the treatment of idiopathic scoliosis in children.
• Aeroplane splint: A complicated splint that holds the arm in abduction at about shoulder level with the forearm midway in flexion Traditional treatment of axillary contractures involved use of aeroplane splints which provided fixed abduction at the shoulder joint.

• Steroids For Reducing Inflammation of Upper Back: Some forms of inflammation and pain in the upper back may be alleviated by steroid (cortisone) or other steroid injections. Dexamethasone, hydrocortisone, betamethasone, and many more fall within this category.
• Analgesics for Pain in Upper Back: Aspirin, ibuprofen, and acetaminophen are examples of painkillers. As well as reducing prostaglandin production, these medications are used to decrease pain. Medication should be used as soon as possible following any cardiovascular event that produces discomfort, but no later than forty-eight hours later.
• Muscle Relaxants for Stiffness in Upper Back: In the case of tense upper back muscles, a doctor may prescribe a muscle relaxant such as metaxalone, methocarbamol, orphenadrine, or carisoprodol.
• Antibiotics for infection in Upper Back: The doctor will likely prescribe antibiotics if he or she concludes that an infection is the primary source of the patient's distress. Primarily, we use amoxicillin, ampicillin, and penicillin.