HomeAnswersOrthopedician and Traumatologyback painWhat could cause intense pain in upper and middle back?

I have intense back pain from upper to middle back. Is it due to pinched nerve?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Manav Gupta

Medically reviewed by

Dr. Vinodhini J.

Published At July 8, 2020
Reviewed AtAugust 22, 2023

Patient's Query

Hello doctor,

I am a 28-year-old female. I had intense back pain from upper to middle back for almost a week. I am not sure if there is a pinched nerve at my back. I have been working out ever since ecq happened. It is hard for me to move for almost a week now. There is a twinge of pain every time I make sudden movements like lying down or deep breathing. Please help.

Answered by Dr. Manav Gupta

Hello,

Welcome to icliniq.com.

From the history you have given, it is a possibility that you might have pinched a nerve or a disc might have bulged causing nerve irritation and reflex muscle spasm (protective) and hence the pain. It could also be other things like posture-related or muscular strain. Is there a history of any trauma? Did you lift heavyweight? Is there any tingling sensation or numbness in legs? Any history of radiation of pain? Is there any history of hypertension diabetes or thyroid issues? For now, you can use hot packs, relative bed rest, and Diclofenac gel for local application. Revert with the info so that I can prescribe you the medications. Generally it takes four to six weeks to heal depending upon the magnitude of nerve irritation. So do not worry about it. But the most important part is to understand the rehab so that there is minimal recurrence.

Patient's Query

Hu doctor,

There is no history of trauma. I lifted weights but it is only 10 lbs total of 20 lbs when I use two dumbells. I have no hypertension and no thyroid. I am a bit worried cause it has been six days. The pain is 7.5/10, but when I am on pain relievers it is 6/10, but when the medicine wears off, it is back to 7.5. Do I need to have an X-ray?

Answered by Dr. Manav Gupta

Hello,

Welcome back to icliniq.com.

Any amount of weight can cause the nerve to be irritated. Yes, if possible do get the X-ray of dorsolumbar spine and thoracic spine AP and lateral view. Do not be worried, it will get better sooner. Take muscle relaxants such as Cyclobenzaprine one tablet HS for five days, Aceclofenac 200 mg controlled release OD for five days, Pantoprazole 40 mg OD before food for five days, and tablet Methylcobalamin 1500 mcg OD for one month. Send me your X-rays and once the pain subsides, you can then progress to the most important part which is strengthening and rehabilitation.

Patient's Query

Hi, Dr. Gupta. Please see my attached xray results. Do I still need a rehab or strengthening? I have a mild thoracolumbar levoscoliosis as per lab result. Please advise what to do. There's still pain :) although it subsided.
Answered by Dr. Manav Gupta
Hello Good to know that the pain is decreasing now The x ray findings are nothing to worry about Due to nerve irritation and reflex muscle spasm the pain occurs It generally decreased in around 7-8 days with proper rest and medications Do continue the medication as i have advised previously Hot fomentation can be done as well The most important part is that we need to avoid the reccurence of this Once the acute phase is over (another 2 weeks) You need to start doing strengthening exercises Back extension exercises 2 sets 10 reps *2-3 sec hold time Gradually increase hold time over 10-15 days as per tolerance Periscapular strengthening exercises to strengthen rhomboid,levator scapulae,latissimus dorsi Rowing using dumbbells 3 sets 10 reps each start with 5 pounds weight Similarly Lats pull down,wall push and shoulder shrugs These will help to strengthen the upper back and interscapular area and help prevent relapse You can learn through videos on youtube and you can set up a video consult to know whether you are doing it correctly. I would advise you to update me on your progress via video consultation (best modality ) or via query Take care Get well soon Regards

Patient's Query

Hi doc gupta, thanks for the recommendations. Will follow it. Thanks. Anyway, few questions: 1. Can I still workout intensely after I heal? Cause I normally workout 5x a week. 2. Can I still lift dumbbells? 3. Can I still back have massages? 4. Since I have levoscolio, do I have restrictions from any movements? Thanks doc
Answered by Dr. Manav Gupta
Hello Yes you can workout intensly but not immediately It will take a few months to regain the same momentum Regarding dumbbells you can start with light weight and gradually progress to heavy ones over time You can have the massage You can do all the movements within limits of pain ( tolerance) Feel free to ask any other question Also follow up in a weeks time Regards

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Manav Gupta
Dr. Manav Gupta

Orthopedician and Traumatology

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