Upper Back Pain Treatment in New York City

A pain management specialist or orthopedic specialist is the right choice for persistent or severe upper back pain. At SPIN, Dr. Melepura is a board-certified interventional pain doctor who specializes in diagnosing and treating thoracic and upper back pain with minimally invasive procedures.

It depends on the cause. Muscle strain usually responds to rest, ice, and physical therapy. Facet joint pain responds well to thoracic facet injections or radiofrequency ablation. Disc-related nerve compression is treated with thoracic epidural steroid injections. Dr. Melepura diagnoses the specific cause before recommending any treatment.

Persistent upper back pain that does not respond to rest and over-the-counter medication usually has an underlying structural cause (such as a herniated disc, facet joint arthritis, or myofascial trigger points) that requires targeted treatment. If your pain has lasted more than two to four weeks, see a specialist.

Burning upper back pain is often caused by nerve irritation or myofascial trigger points. Ice or heat, anti-inflammatory medication, and gentle stretching can help temporarily. If the burning is persistent, radiates into your chest or arm, or is accompanied by numbness or weakness, see a pain specialist promptly: these can be signs of thoracic nerve compression.

Yes, the vast majority of upper back pain is treated without surgery. When it doesn't settle with physical therapy and medication, options such as thoracic epidural injections, facet injections, radiofrequency ablation and trigger point injections can help. At SPIN, surgery is considered only after conservative and minimally invasive options have been tried.

SPIN coordinates MRI referrals for patients who need imaging to diagnose thoracic spine conditions. We work with NYC imaging centers to arrange prompt appointments, often within the same week. If you already have MRI images, bring them to your first visit and Dr. Melepura will review them.

The upper back has 12 pairs of thoracic spinal nerves, one pair leaving the spine at each vertebra from T1 to T12. Most continue along the ribs as intercostal nerves, which is why upper back nerve pain often wraps around the chest. Some muscles between the shoulder blades are supplied by nerves from the neck instead.

Usually burning, sharp or electric rather than a dull ache. It often follows a band from the spine around the ribs on one side, and can come with tingling or numbness of the skin. Twisting, deep breaths, coughing or sneezing can make it worse.

Most often a strained muscle, an irritated rib joint or facet joint, or a nerve along a rib on that side. Less often, the pain comes from an organ such as the heart, lungs or kidneys. See a doctor if it hasn't improved within a couple of weeks, and call 911 if it comes with chest pain, shortness of breath, sweating or nausea.

Call 911 if upper back pain comes with chest pain or pressure, shortness of breath, sweating, nausea, or pain spreading to your arm, neck or jaw, as these can be signs of a heart attack. Go to the emergency room for upper back pain after a fall or accident, with a high fever, or with new weakness, numbness, or loss of bladder or bowel control.

Muscle pain is usually a dull ache or tightness that gets worse with certain movements or after long hours at a desk, often with tender spots you can press on. It tends to ease with heat, rest and gentle stretching. Pain that is burning, sharp or electric, wraps around your ribs, or comes with numbness, tingling or weakness points more to a nerve. Pain that doesn't change when you move, or that comes with chest pain, shortness of breath or fever, needs a doctor.

Not every cause can be prevented, but a few habits lower the risk. Take regular breaks from your desk or phone, keep your screen at eye level, and keep your shoulders back rather than rounded. Stay active and strengthen the muscles between your shoulder blades. Lift with your legs, carry heavy bags on both shoulders, and sleep with a pillow that keeps your neck level.

Rarely. Most upper back pain comes from muscles, joints or nerves. See a doctor promptly if the pain comes with unexplained weight loss, fever, night pain that doesn't ease when you change position, a history of cancer, or pain that keeps getting worse despite rest and treatment.