Neck and upper back pain is one of the most common combination syndromes affecting the cervical and thoracic spinal zones. The neck encompasses the 7 cervical spinal vertebral bones, as well as the 6 intervertebral discs from C2/3 to C7/T1. The upper back is traditionally defined as the top half of the thoracic spine, encompassing the T1 through T6 vertebral bones and the spinal discs from T1/T2 to T6/T7.
The spine is a multi-zone structure that relies on all parts working optimally in order to provide full functionality. When one zone is deficient, the others will suffer, most markedly at the nearest levels. Likewise, the muscles of the neck and upper back work together to accomplish many anatomical tasks and are sure to influence each others functionality if either area suffers injury, degeneration or pathology.
This essay explores the causes, symptoms and recommendations for pain that exists in the neck and upper back simultaneously. If you have pain in the neck and upper back, then this is the right discussion for you.
Neck and Upper Back Pain Sources
Single location neck pain and upper back pain can come from a diverse range of sources, including muscular, spinal, systemic, disease-related and mindbody issues. We detail many of these causes throughout this website, and focus on them in our neck pain causes and upper back pain causes articles. Almost any of these causes can create pain in multiple areas of the spine, as well, but some are more frequently observed than others, including:
Degenerative processes tend to cascade in significantly affected regions. Once a focal area of degeneration affecting the discs, bones or joints exists, the patient will often favor the area functionally and create the ideal circumstances for structural deterioration to spread to nearby spinal levels. Similarly, some types of treatment for degenerative conditions might also encourage further and escalated degeneration in nearby spinal locations, as is seen often with spinal fusion surgery and steroid injections.
Muscular neck pain and muscular upper back pain tend to affect large regional areas of the dorsal anatomy, which is logical. The neck and back muscles are layered and interdependent, making them highly influential on each others forms and functionality.
Abnormalities of curvature often affect both the spine itself in nearby levels, as well as the muscles that must support the compromised section of abnormally curved vertebral column. This includes both lateral and sagittal spinal curvature irregularities like scoliosis, lordosis and kyphosis.
Vertebral migration, such as spondylolisthesis, and facet joint pathology might create micro or macro instability in the backbone, often affecting large tracts of spine, such as the neck and upper back.
Neck and Upper Back Symptoms
The expressed symptoms of combination neck and upper back pain will vary to some extent, depending on the nature of the diagnosis. However, many conditions will produce strikingly similar symptoms even though the root causation is different in each case:
Tension and stiffness is virtually universal in the neck and upper back. Patients might have a difficult time performing strenuous activities with their arms, as well as moving their head. Head rotation, neck extension, and/or neck flexion might all become symptomatic exacerbators.
Neck pain and back pain might be localized over the spine or off-center in the dorsal muscles. Pain might be focal or diffuse, radiating, shooting, acute or chronic.
Wide-ranging neurological expressions may be present, including symptoms of pain, tingling, weakness or numbness in the face, ear, lower head, shoulders, arms and or hands. In less common cases, patients might suffer lower body symptomology, as well, including sciatica, sexual dysfunction, incontinence and the inability to stand or ambulate.
Neck and Upper Back Pain Recommendations
Combination neck and upper back pain syndromes are actually very common and affect more patients than pain syndromes that only affect the neck or only affect the upper back. This fact demonstrates the truly close relationship of all the tissues in the upper spinal column, including the bones, discs, ligaments and muscular support and mobilization tissues.
We highly recommend that patients seek out qualified diagnostic evaluation from more than one type of doctor before making a decision on the best path towards treatment. Misdiagnosis is always a serious threat to consider and this awful fate puts many patients directly on the road towards failed therapy and unnecessary surgery. We suggest consulting a neurologist and a physical therapist at the very least, with the addition of an orthopedist being a wise inclusion, as well. It is always best to keep each doctor’s opinion private from others so that there will be no tendency to concur just to maintain the bonds of medical fraternity…
Many symptoms of neck and upper back pain will assist in diagnosing the true source of pain, so be sure to include symptomatic correlation as a primary tool during diagnostic processing. This can even be largely self-managed, since no one is better informed on how the condition feels than the patient themselves. Therefore, all patients are encouraged to take very active roles in their diagnosis and treatment to achieve the very best therapeutic outcomes possible.
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