Upper Back & Rib Pain
Upper back pain (or thoracic pain) is one of the most common injuries in modern society. Injuries can vary from simple to complex. They can also result from posture or fatigue strain injuries, lifting injuries, falls, or even a result of arm use, e.g. throwing injury.
The following links provide upper back pain and thoracic spine injury information plus guidance. For specific advice specific to your upper back pain, please consult your spinal health practitioner or doctor.
Thoracic Spine Red Flags
While most upper back pain is relatively straightforward from a diagnostic perspective and responds quickly to treatment, other potential sources of the thoracic cage and chest pain can be more sinister and require urgent intervention.
Cardiac conditions and malignancy are just a couple of potentially life-changing sources of upper back pain that you should investigate and treat without delay. Due to the thoracic spine being more likely to be caused by a serious pathology when compared to your neck or lower back, it is also wise to consult with your trusted healthcare practitioner. You should certainly consult with your healthcare practitioner if you have any of the following red flags.
Red flags for possible serious spinal pathology include:
- History of cancer, drug abuse, HIV, immunosuppression or prolonged use of corticosteroids.
- Fever, chills, unexplained weight loss, or recent bacterial infection.
- Pain that is:
- Constant, severe and progressive.
- Non-mechanical without relief from bed rest or postural modification.
- Unchanged despite treatment for 2-4 weeks.
- Accompanied by severe morning stiffness (rheumatoid arthritis and ankylosing spondylitis).
- Recent violent trauma (such as a vehicle accident or a fall from a height) or a spine structure deformity.
- Minor trauma, or even just strenuous lifting, in people with osteoporosis.
- New back pain with age at onset < 20 or > 50 years of age.
- Severe or progressive neurological deficits (muscle weakness, sensation/reflexes) in the lower extremities.
If you feel that you have any of the above symptoms, we recommend an urgent medical assessment.
Common Causes of Upper Back Pain & Injury
Thoracic Spine Conditions
- Scheuermann's Disease
- Spinal Stenosis
- Rib Stress Fracture
Nerve-Related / Referred Pain
Youth Spinal Pain
Teenager Neck & Back Pain
Teenagers can be particularly vulnerable to back pain, mainly due to a combination of high flexibility and low muscle strength and posture control.
The competitive athlete and most individuals who exercise regularly or maintain fitness and core stability control are less prone to spine injury and problems due to the strength and flexibility of supporting structures. Luckily, issues involving the lower lumbar spine are rare in athletes and account for less than 10% of sports-related injuries. Injuries do occur in contact sports and with repetitive strain sports. Your physiotherapist can assist in the resolution of any deficits in this area.
Sports such as gymnastics, cricket fast bowlers, and tennis have a higher incidence of associated lumbar spine problems related to repetitive twisting and hyper-bending motions.
Spondylolisthesis is a significant concern and needs to be appropriately treated by a physiotherapist with a particular interest in these types of injuries. Luckily, most injuries are minor, self-limited, and respond quickly to physiotherapy treatment.
Common Adolescent Spinal Injuries
Lower Back (Lumbar Spine)
Midback (Thoracic Spine)
Neck (Cervical Spine)
For specific advice regarding youth neck or back pain, please seek the professional advice of your trusted spinal physiotherapist or doctor.