Burning Sensation in the Middle Back?

Do you ever suffer from middle back pain in between your shoulder blades when sitting at work, in your car, or when watching TV? Have you ever tried rolling this area out with a lacrosse ball or foam roller only to get temporary relief? 

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This is a very common issue that affects many people. Because we have muscles that sit directly in between our shoulder blades, many people are made to believe that their pain is associated with a strain, or trigger point (“knot”) of that muscle. These muscles “the rhomboids” are rarely the issue. To help treat this issue we need to look at the whole picture versus just the area that causes us discomfort. 

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All right “know it all” physical therapist, if the pain is not coming  from the muscles in that area then what could it be? There are many variables that can cause pain in this area but research has shown that a lot of cervical (neck) dysfunction can cause pain in this middle/upper back region. 

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Weird right? This is called referred pain (when you have an injury in one area of your body but feel pain somewhere else). Irritation of cervical (neck) nerves and degeneration of the vertebral disc of the neck can lead to pain in this area. So although you feel pain in that middle shoulder blade area, that may be a secondary response to what is happening at the neck. 

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It also can be caused by issues occurring in the thoracic spine (upper back ) or shoulder. The shoulder blades sit on top of the thoracic spine so dysfunction such as stiff thoracic spine or shoulders can lead to some discomfort in this area. 

Symptoms of Middle Back Pain

Symptoms will vary  depending on the cause and severity of the patient’s condition. For some people, middle back pain will be brief and mild, going away after just a few days. For others, the pain may be chronic, getting worse and worse over time, interfering with their ability to complete their daily tasks.

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The symptoms most commonly associated with middle back pain include sharp, stabbing pain, a  general aching sensation, stiffness and/or reduced mobility, radiating pain that travels into the arms, tingling, numbness, and weakness.  Typically most patients won’t experience all of these symptoms.

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Who Is More At Risk?

• People who have jobs where they have to sit for long periods of time. 
• Individuals with a history of neck dysfunctions such as herniated discs/arthritis.
• Individuals who have a manually intensive job and/or lift frequently with poor form.
• People with scoliosis.
• People with pronounced rounding in their upper back commonly called Dowagers hump.
• In more severe cases middle back pain may result from a heart attack, an aortic aneurysm or lung cancer. 
• Middle back pain occurs frequently to those who sit at a desk all day.

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How Can Middle Back Pain Be Solved by Physical Therapy?

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Many times less invasive care, such as  physical therapy, can help reduce symptoms, strengthen the areas affected and even cure the problem completely.

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Here are a list of potential causes of middle back pain that we can work on in physical therapy:

• Poor posture when sitting.
• Weak middle back/shoulder blade muscles.
• Tightness in the neck (cervical spine) and middle back (thoracic spine).
• Limited shoulder motion.
• Poor workplace ergonomics.
• Decreased shoulder blade motion.
• Poor biomechanics when lifting.

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Somethings you can do on your own to help reduce burning middle back pain

A key to treating middle back pain  is trying to  change what you can control. 

For example:

• Stress: try to pick up healthy habits that help manage your daily stressors such as learning deep breathing techniques, meditation, journaling and therapy.

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• Sleep: Try the 10-3-2-1 rule
  • 10 hours before bed no more caffeine: caffeine blocks the action of adenosine, the neurotransmitter which promotes sleep. Caffeine can have a half life of up to 6 hours. 10 hours gives you sufficient time as everybody responds differently to caffeine. 
  • 3 hours before bed no more food or alcohol: alcohol can reduce the amount of REM sleep which is crucial for mental processing, leaving you groggy the next day.
  • 2 hours before bed no more work: when we are working our brains are operating in a fight and flight response.
  • 1 hour before bed no more screen time: the blue light from the screens confuses the brain and makes it feel like its day time interrupting your natural sleep cycle.

• Prolonged inactivity: Lack of movement can cause the neck and upper back to stiffen up which can cause more discomfort:
  • Set a timer for every 30 minutes as a cue to get up from your work desk, pause Netflix or take a break from your book to get up and stretch.

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Exercises That May Help With Middle Back Pain

If you click on the exercise IT WILL TAKE YOU TO A VIDEO DEMONSTRATION OF THE EXERCISE!

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• Open books
• Cat/Cow
• Thoracic extension with foam roller
• Foam roll field goal
• Serratus Slides

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