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.
Kyphosis refers to the normal rounding of the upper back. Occasionally, people will have excessive rounding and in this case the rounding/kyphosis is referred to as hyperkyphosis (hyper = above normal). This rounding increases naturally as we age and there is no standard definition of hyperkyphosis versus normal changes associated with aging. An increase in kyphosis is more common in women than men. The cause of an increase in kyphosis is due to muscle weakness and impairments in flexibility/mobility.
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