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Paul asked...

I have been experiencing upper back pain for several months...

I have been experiencing upper back pain for several months, I have been seeing a Physio therapist at work who cracked my back a few times and ever since my back seems to have gotten worse over time, I have a sort of dull pain on the right side of my spine and muscles which seems to get worse after a heavy demanding workload and when I try to go to sleep, I am only managing 1-2 hours and then im awake hot and sweating and can't seem to drop back off and get enough sleep ready for the next day. I am finding it hard to see my gp as I want him to send me to a specialist for an X-ray or Mri to find out what the problem is, could you advise me please on what I can do, I am still going to try and see my gp in the meanwhile for a referral.

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The answer

Thank you for contacting us, we're sorry to hear about the problems you are having in your upper back.

Upper back pain usually occurs through trauma or sudden injury to the back- although we note you do not mention any trauma to that area of the body- and also through strain and poor posture over time. These are the two most common reasons we see upper back pain in people, more recently upper back pain has become a familiar complaint from people who work at computers most of the day for example.

The vast majority of upper back pain is thought to be caused through either muscle irritation known as myofascial pain or joint dysfunction. From the symptoms you are describing it is likely that the pain you are experiencing is related to the large muscles in your upper back and there may also be some muscle spasm and tightening occurring in the affected area which is increasing your pain further. These large muscles that lie at the back of the thoracic area are prone to developing irritation and can be painful and difficult to work out. Often this type of muscle irritation can be due to weakness in the muscle, de conditioning or repetitive strain on the area causing an over use injury. Sports injuries, muscle strains and car accidents for example can all be contributing factors.

Once an assessment has been made of whether it is a muscle or a joint problem treatment for muscle irritation is usually comprised of a mixture of active and passive physiotherapy, massage therapy and acupuncture if it is thought to be helpful. If the problem is in one of the joints of the back treatment will be determined according to the problem found but is likely to include muscle relief techniques such as we’ve described as well.

If you are unable to get an appointment with your Gp to discuss this issue you can always ask for a telephone appointment instead to talk your concerns through while waiting to be seen by them when an appointment is available. They may agree to send you for an x ray or scan as you are hoping and you would be able to discuss the level of pain that you have been getting as they should be able to prescribe some appropriate analgesia to take to relieve this for you.

If you have a policy with us at AXA-PPP you may also like to consider speaking to your claims team about a Working Body Referral, this will put you in touch with a physiotherapist who will be able to perform a thorough assessment of your problems and draw up a programme of treatment for you as well.

We do hope you will find the above information of use, best of luck in getting this resolved too.

Answered by the Health at Hand nurses