Can the neck refer pain to the upper back/thoracic spine?
If your pain is in the region between the neck and the shoulder, between or around the shoulder blades or you have both neck and upper back pain, odds are the neck is involved. This is especially true if you also have neck pain. In the 1950s, a study injected irritates into different levels of the neck and found neck pain commonly refers to the area between the shoulder blades and to the shoulder blades themselves. Because this is extremely common, we often assess (if indicated) the neck on patients with upper back pain to see if we can reproduce your exact symptoms with neck testing. If this is the case, we will likely start with treatment at the neck first to see if it makes a difference in your upper back pain and activities you are limited in performing. If we determine the neck is not involved, treatment will be directed towards the upper back.
- Cloward, R., 1959. Cervical Diskography. A Contribution to the Etiology and Mechanism of Neck, Shoulder and Arm Pain. Annals of Surgery, 150(6), pp.1052-1064.
To determine if a patient needs to be sent to another provider for an X-ray, MRI or other form of medical imaging, we want to be 100% certain a red flag is not present.
For the spine, there is not always a clear black and white answer of the specific anatomical structure causing thoracic pain/symptoms and patients often get hung up on wanting a firm anatomical diagnosis.
Thoracic pain and mobility deficits We often see patients with both thoracic...