Osteoporosis : Introduction & Causes

Osteoporosis can have several causes, some of which are hereditary and some of which come from your lifestyle. Some osteoporosis causes you can't control are:

• Family History: If someone in your family has or had osteoporosis, you're more at risk.
• Gender: Women are simply more likely to develop osteoporosis.
• Ethnicity: White and Asian people are more likely to be affected by osteoporosis than black or Hispanic people, but this does not mean that black or Hispanic people are not at risk.

Then there are causes that you can somewhat control but are also partly out of your hands:

• Estrogen Levels: Estrogen protects bones, so if you have low estrogen levels, you're more at risk for developing osteoporosis. Menopause causes a fast decrease in estrogen levels, which is why if you're a post-menopausal woman, you need to be especially vigilant about your bone health. Women may lose bone at a rate of 4 to 8% per year for several years after their ovaries stop producing estrogen.
  
  Also, if you've had your ovaries removed, your osteoporosis risk increases because the ovaries produce a lot of your estrogen.
  
  As a post-menopausal woman or a woman who's had her ovaries removed, you may want to ask your doct estrogen therapy to increase your hormone levels.
  
  Even if you're a young woman now, years from menopause, you should be thinking about your estrogen levels. Irregular periods can indicate low estrogen levels—and serve as an early warning to take care of your bones. Irregular periods may also result from over-exercising or under-eating, both of which can increase bone loss.
  
  Men also have estrogen, but for them, it's the testosterone that protects the bones. If they have low levels of sex hormones, they're more at risk.
• History of Broken Bones: If you've broken bones in the past, you could be more at risk for osteoporosis because the broken bone(s) probably lowered your bone mineral densiry (BMD).
• Low Body Weight: Petite and small boned women (under 130 pounds) have less bone mass to begin with, so they need to be particularly vigilant about their bone health.

Osteoporosis is also caused by factors that are completely in your control, and this is what makes osteoporosis preventable. In thinking about your bones, you should be considering:

• Diet: Every day, you should be getting the proper amounts of various minerals and vitamins that promote bone growth. What you eat can have a significant impact on your chances of developing osteoporosis. Some foods promote bone growth, while others may stunt it.

  • Calcium: Calcium gives your bones what they need to grow and regenerate. If you don't get enough calcium every day, your bones will be weaker. How much calcium you need varies by your age.

  • Vitamin D: Calcium needs vitamin D; without it, your body can't absorb and use calcium as effectively. Without enough vitamin D in your diet, some of your calcium intake could be going to waste, adversely affecting your bones. Like calcium, the amount needed changes throughout life.

  • Other Vitamins and Minerals: Phosphorous, magnesium, vitamin K, vitamin B6, and vitamin B12 are all also important to bone growth. Fortunately, a well-balanced diet almost guarantees that you'll be getting enough of these. If you aren't getting enough and want to promote good bone health, you might need to take a supplement.

  Sadly, anyone who had a poor diet growing up, either because of poverty or poor eating habits, may not have gotten enough calcium and other minerals to build strong bones.
  Sometimes, having too much of something in your diet can harm your bones. (Everything in moderation; that's the lesson to learn from this.) You should monitor your intake of:

  • Protein: Yes, you should get the right amount of protein; however, too much protein can actually make you lose calcium.

  • Caffeine: Too much caffeine limits how well your body absorbs calcium. 

• Exercise: A good workout routine will strengthen your bones, and you should have a mix of weight-bearing exercise (e.g., walking) and strengthening exercises (e.g., weight lifting). However, if you don't exercise, your bones become weaker and osteoporosis can develop.
• Smoking: Smoking can increase your chances for getting osteoporosis in a few ways—the chemicals make it harder for your body to use calcium, plus they make it harder for estrogen to do one of its jobs and protect your bones.

• Alcohol: A lot of alcohol—abusing it—can lower your calcium supply and how efficiently your body uses calcium.

Osteoporosis can be caused by a medical condition or medication, and that's called secondary osteoporosis.

Medical conditions that can lead to osteoporosis (not an exhaustive list):

• Intestinal problems: These can interfere with absorption of calcium and vitamin D, which makes it harder for your body to regenerate bones. Inflammatory Bowel Disease is an example.
   
• Kidney problems: Kidney issues can cause calcium loss, upsetting the balance of bone loss and growth.
• Parathyroid and thyroid problems: Hyperparathyroidism causes your body to create too much parathyroid hormone (PTH), and that leads to bone loss. This article has more information about parathyroid disease and osteoporosis.
  
  Hyperthyroidism puts too much of the thyroid hormone in your body, potentially weakening your bones.
• Nutrient absorption problems: People with celiac disease have trouble absorbing nutrients like calcium and vitamin D, and without those, it's harder to maintain health bones.

Medications that can lead to osteoporosis (not an exhaustive list):

• Corticosteroids: Prednisone is a corticosteroid that can cause excessive bone loss.
• Thyroid hormones: If you have an underactive thyroid, you may need to take medication to increase your thyroid levels. However, you can take too much, which will weaken your bones.
• Some anti-convulsants or anti-seizure medications: Dilantin is one example.
• Antacids with aluminum

Read more about : 

Back pain in relation with obesity

Back pain can be reduced by Vitamin D

Source : http://www.spineuniverse.com/conditions/osteoporosis/causes-osteoporosis

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Back pain in relation with obesity

Many important medical associations now define obesity as a disease. Being overweight or obese is a serious disorder that affects adults and children. Most people know that obesity contributes to the development of coronary heart disease, diabetes, high blood pressure, and colon cancer. However, did you know that obesity is a contributing factor to back pain? It's true. Being overweight or obese can significantly contribute to symptoms associated with osteoporosis, osteoarthritis (OA), rheumatoid arthritis (RA), degenerative disc disease (DDD), spinal stenosis, and spondylolisthesis.

How Being Overweight or Obese Can Affect the Spine

The spine is designed to carry the body's weight and distribute the loads encountered during rest and activity. When excess weight is carried, the spine is forced to assimilate the burden, which may lead to structural compromise and damage (eg, injury, sciatica). One region of the spine that is most vulnerable to the effects of obesity is the low back—the lumbar spine.

Why Exercise is Important

Lack of exercise can lead to poor flexibility and weak muscles in the back, pelvis, and thighs. This can increase the curve of the lower back, causing the pelvis to tilt too far forward. Further, this is detrimental to proper posture and as posture weakens, other regions of the spine (neck) may become painful.

Back Pain Only Age-related?

You may try to dismiss the cause of some of these spinal disorders to the process of normal aging. It is true that with age, body tissues can cause changes to spinal anatomy. However, if you are overweight or obese, chances are you have, or will have, back pain. You may have or develop one of the following conditions:

• Posture: Unhealthy posture accounts for neck and back pain. A level of physical fitness is necessary to properly support the spine. 

• Low Back Pain: Obesity may aggravate an existing low back problem and contribute to recurrence of the condition.

• Osteoporosis: A sedentary lifestyle coupled with an unbalanced diet can affect the density, or strength of the bones (spinal vertebrae). When the structural architecture of a vertebral body is compromised, it is at risk for fracture. Vertebral fractures can be painful and disabling. If you have been diagnosed with osteoporosis, you have probably lost between 25% to 30% of desirable bone density. 

• Osteoarthritis (OA) and Rheumatoid Arthritis (RA): The joints in the spine are called facet joints. Excessive body weight places unnatural pressure and stress on the joints during movement and at rest.

Development of Obesity 

Industrialization and modernization has had a tremendous impact on our food. Food can be purchased just about anywhere. No longer is it necessary to expend physical effort to hunt and forage for food. There are vast numbers of processed food products available and labor-saving devices (eg, microwave ovens) to cook food. The market for many convenience foods and kitchen devices came about when women entered the workforce.

For the time period 2011-2012, the following statistics were published:

• 34.9% of adults (age 20 and older) were obese
• 16.9% of children and adolescents (ages 2-19) were obese

Are you overweight or obese?
If you are overweight or obese, there are many tools available that can help you lose and maintain a healthier body weight. How to get started? Talk with your physician or spine specialist to find out how to safely start a weight loss program. This is important because if you have back pain, your exercise program will probably be different than for a person without back pain. Remember, no two people are the same, and considering that obesity is a disease, obtaining professional help may be the best first step for you.

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Back pain can be reduced by Vitamin D

Chronic back pain—the kind where you keep going to doctors and they can't find any specific problem—can be defeating. Try as you may, it seems that nothing takes away that general ache that can make it hard to do even the simplest things, like get out of bed.

It may be time for chronic back pain sufferers to walk on the sunny side of the street.

That's not a trite, "oh, just pull yourself together and get over it" statement. Vitamin D—aka, the sunshine vitamin—has been shown to help patients with chronic musculoskeletal pain. We get vitamin D from the sun (and from other sources, as explained in Calcium and Vitamin D to Build Bone); when the sun's rays hit your skin, your body becomes a vitamin D factory. Amazing.

Vitamin D helps your body absorb calcium, so without enough vitamin D, you won't get enough calcium. Without enough calcium, your bones can weaken, potentially leading to bone and joint pain, or musculoskeletal pain. (Lack of calcium and vitamin D can also lead to osteoporosis, as explained in Causes of Osteoporosis.) A recent review of clinical research by Pain Treatment Topics found that people with chronic musculoskeletal back pain always had insufficient levels of vitamin D. Then, when they bumped up their intake of vitamin D, their pain lessened dramatically.

This doesn't mean that you can just go on a picnic on a sunny day and take a few vitamin D supplements—and presto, your back pain is gone. Talk to your health care provider about how much vitamin D you should get every day and how you can get enough of it.

You won't notice an immediate effect from vitamin D; give it time to build up in your body and treat the source of your pain (your weakened bones and joints). Taking vitamin D is a commitment, and you should also stay committed to your other treatment options, such as pain medications and physical therapy. A multi-disciplinary approach like that is generally more effective than trying just one treatment at a time.

And if possible, get outside more on sunny days. That sunshine vitamin—vitamin D—may be just what your back needs.

Read more about :  Neck pain medications

Source :  http://www.spineuniverse.com/conditions/back-pain/vitamin-d-can-reduce-back-pain

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Lumbar radiculopathy : introduction, diagnosis & treatment

Approximately 80% of the population is plagued at one time or another by back pain, especially lower back pain. Associated leg pain (called lumbar radiculopathy or sciatica) occurs less frequently. Pain can be bothersome and debilitating, limiting daily activities. Leg and back pain can be caused by a variety of reasons, not all of which originate in your spine.

For the purpose of this article, we will focus on lumbar radiculopathy, which refers to pain in the lower extremities in a dermatomal pattern (see image below). A dermatome is a specific area in the lower extremity that has nerves going to it from a specific lumbar nerve. This pain is caused by compression of the roots of the spinal nerves in the lumbar region of the spine. Diagnosing leg and lower back pain begins with a detailed patient history and examination.

Dermatomes (above): Where you feel back and/or leg pain
may help your doctor diagnose nerve compression.

Medical History: Important when Diagnosing Lower Back Pain and Sciatica

Your medical history helps the physician understand the problem. It is important to be specific when answering medical questions related to pain onset but remembering every detail is often not critical. Keeping records of your medical history, including medical problems, medications you are taking and surgeries you have had in the past is helpful.

Journal Your Back and Leg Pain

Regarding your leg and back pain, it may be helpful to keep a journal of your activities, documenting when the pain began, the activities that aggravate your pain and those that relieve your symptoms. It is also important to determine whether your back pain is more bothersome than your leg pain or visa versa. You may be asked if you are experiencing any numbness or weakness in your legs or any difficulty walking. Remember, understanding the cause of your problem is based on the information you provide.

Most people describe radicular pain as a sharp or burning pain that shoots down the leg. This is what some people call sciatica. This pain may or may not begin in the low back. Leg pain caused by compressed nerve roots generally has specific patterns. These patterns of pain depend on the level of the nerve being compressed. After reviewing your history, your physician will perform a physical examination. This will help the physician determine if your symptoms are due to a problem that is caused by spinal nerve root compression. To help you understand the exam performed by your physician lets pause for a quick anatomy lesson.

Spinal Anatomy: Helpful for Understanding Your Lower Back Pain

The spine is comprised of 33 vertebrae (bones stacked on top of each other in a "building-block" fashion) that have 4 distinct regions: cervical (neck), thoracic (upper/mid back), lumbar (low back), and sacrum (pelvis).

Discs are cushion-like tissues that separate most vertebrae and act as the spine's shock absorbing system. Eaach disc is comprised of a tough outer ring of fibers called the annulus fibrosus, and a soft gel-like center called the nucleus pulposus.

There are 7 flexible cervical (neck) vertebrae that help to support the head. Twelve thoracic vertebrae attach to ribs. Next, are 5 lumbar vertebrae; they are large and carry the majority of the body weight. The sacral region helps distribute the body weight to the pelvis and hips.

The spinal cord is housed within the protective elements of spinal canal. Spinal nerves branch from the spinal cord and exit the spinal canal through passageways between the vertebral bodies. The passageways are called neuroforamen. Nerves provide sensory (allowing you to touch and feel) and motor information (allowing the muscles to function) to the entire body.

In the next article (click the Continue Reading link below), we discuss how your doctor determines what is causing your lower back pain and sciatica, which is essential to the proper treatment plan and symptom relief.

Commentary by a Spine Expert

Lumbar radiculopathy is a common problem that results when nerve roots are compressed or irritated. This excellent article discusses the basic anatomy and clinical manifestations of lumbar radiculopathy, which is often referred to generically as sciatica. These symptoms can be due to a variety of causes such as disc bulges, degenerative narrowing of the space for the nerves (spinal stenosis or foraminal stenosis), spinal instability, deformity of the vertebrae, or herniated disc fragments outside of the disc space.

In 70-80% of patients, sciatica is transient, and resolves with nonsurgical treatments such as anti-inflammatory medications, physical therapy, exercise, spinal manipulation, or other nonsurgical modalities. A proportion of patients with sciatica require surgical intervention in instances where nonsurgical therapies have failed to provide adequate pain relief, and there is pathology [cause] that is present compressing the nerves. A very small proportion of patients require urgent surgery. If a very large lumbar disc herniation causes severe nerve damage, with paralysis or acute bowel or bladder incontinence, then emergency surgery may be required.

Physical Examination to Diagnose Low Back Pain

During the physical and neurological examination, the physician observes your ability to move (range of motion) and movements that are difficult and/or that cause symptoms. Your reflexes are also tested and may reveal important findings about which nerve root(s) may be compressed.

In the table below, "L" means lumbar (low back) and "S" means sacral (back of the pelvis). The number that follows denotes the level in the particular region of the spine.

The table (below) shows what findings your physician may find during his/her examination.

Nerve Root Involved	Possible Exam Findings with Nerve Root Compression
L2	Decreased hip flexor strength (hip flexor muscles allow you to lift your knee toward your chest)
L3	Decreased patellar reflex (knee jerk response) Sensation loss of the anterior thigh (front of one or both thighs) Weakness in quadriceps muscle (a large muscle group at the front of each thigh) Pain in the area of the anterior thigh (front of a thigh)
L4	Sensory loss of the anterior, lateral or medial foot (front, side or inside of a foot) Possible decreased patellar tendon reflex (knee jerk response) Weakness of the quadriceps muscle Pain in the area of the anterior leg (front of a leg)
L5	Sensory loss in the dorsum (top) of the foot and great toe Weakness of the anterior tibialis (front of a shinbone) , great toe (extensor hallicus longus), and hip abductors (moves a leg outward from the hip) Pain down the side of the leg
S1	Decreased Achilles reflex (heel) Sensory loss of the lateral (side) foot and the small toe Weakness of the gastrocnemius (calf muscle), gluteus maximus (buttock muscle), plantar flexor (enables you to point your foot), and great toe Pain down the back of the leg into the bottom or side of the foot

Imaging Tests Help Confirm the Diagnosis

To further determine the source of your symptoms, and to confirm your diagnosis, your physician may request other tests such as an X-ray or MRI (magnetic resonance imaging).

• An x-ray is used to show the bony anatomy of the spine. In an x-ray, the physician is looking for the alignment and integrity of the bony structures. Integrity in this sense means no degeneration in the bone structures.

• An MRI produces images of the soft tissues of the spine. Using an MRI, the physician looks at the soft tissue structures such as the discs, ligaments, spinal cord, and spinal nerves. The physician looks at the integrity of the discs themselves for degeneration (dark in color because of loss of hydration), bulging or herniation (where the disc contents protrude into the spinal canal and compress the nerves or spinal cord). If there is a herniation present, the MRI helps the physician determine if the nerves are being pinched or smashed by the herniated disc.

Treatments

Low back pain with lumbar radiculopathy is often treated conservatively. These non-surgical treatments may include a combination of:

• Rest
• Medication
• Spinal injections are dual purpose; may manage pain andprovide diagnostic information
• Home exercise or structured physical therapy program

Spine surgery may be recommended if symptoms persist after a period of conservative treatment. These symptoms may include severe pain, increasing numbness, or weakness of the legs. The decision for surgical intervention is often made when conservative treatment has failed and the symptoms are interfering with your daily function causing lifestyle changes such as an inability to work or participate in the activities you enjoy.

Read more about :  Ankylosing spondylitis : introduction & management

Source :  http://www.spineuniverse.com/conditions/back-pain/low-back-pain/lumbar-radiculopathy-low-back-leg-pain

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Back pain in relation with economic crisis

We are not a society that deals well with stress. This is why there are entire industries devoted to making Americans calm down.

And we, as a country, are now officially stressed out because of the economic crisis. All 300 million of us (ok, it's less than that because the babies probably aren't stressed) tense up at the mere mention of the markets and the bailouts.

Unfortunately, our bodies don't do much better in dealing with stress. Or to put it more accurately: when we're stressed, we stop paying attention to our bodies and that can cause a world of hurt, especially for our spines.

The spine is already under a lot of stress. For Pete's sake, it has to cushion all your movements and distribute your weight and hold you upright and deal with all the crummy stuff you do to it (weekend warriors, I'm looking at you).

Then, when you become stressed out because of your 401(k), your mortgage, how your bank went under—just a few examples off the top of my head—your back and neck don't stand a chance. Stress is a contributing factor in many cases of back pain and neck pain.

Now that we've been in this "biggest economic downturn since the Great Depression" phase for over a year, I bet a lot of people are reaching for the Aleve.

However, I bet a lot more people are spending myriad hours hunched over a computer…because as I said, we're not a society that deals well with stress and stress-related pain. Our usual response is to ignore it and maybe even to work more, and that's a really bad response.

What to Do in the Current Economic Crisis

I hope you aren't looking here for answers about what to invest in to re-coup your retirement savings. Although maybe you should invest in things like Aleve and Tylenol because you know people are in pain. (Please don't actually take my advice. I'm a writer; what do I really know about stocks?)

No, I have some tips for you about how to deal with stress caused by the economic crisis:

• Don't cut out exercise. If you're cutting back on expenses, you may have to cancel your gym membership. However, you don't need a gym membership to take a brisk walk outside at lunchtime.
  
  We all know the emotional benefits of exercise. For example, it releases endorphins, one of our body's natural good mood promoters. So after you exercise, you may actually feel more optimistic—or at least more Zen—about life's stressors.
  
  A regular exercise program is also a vital part of taking care of your spine, as you can read in this exercise article. Therefore, if you're exercising, your spine is better able to handle stress.
• Take breaks at work. Walk away from your computer. Frequent breaks also prevent you from sitting in one position all day—a very bad habit that can lead to tense muscles and back and / or neck pain. Get more tips about how to take care of your spine at work.
• Read the article Tame Stress to Reduce Back and Neck Pain. It's full of tips that will help you relax and avoid back pain and neck pain.

Read more about :    Neck pain types

Source : http://www.spineuniverse.com/conditions/back-pain/economic-crisis-back-pain

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Upper Back Pain : Anatomy, Symptoms, Causes & Diagnosis

Anatomy of the Upper Back

Your thoracic spine—the upper back or mid-back region—is the most stable part of your spine. It is very stiff, and the thoracic spine has a limited range of motion. It is like that for several reasons, all of which you can understand by looking at the anatomy of the thoracic spine.

Vertebrae

There are 12 vertebrae in the thoracic spine. They are labeled T1 through T12; the T stands for thoracic. You have more vertebrae in your thoracic spine than you do in any other spinal region. (The cervical spine—the neck—has 7 vertebrae, and the lumbar spine—the low back—has 5 vertebrae. There's also the sacrum and coccyx, which are 5 fused vertebrae and your tailbone.) The thoracic spine extends from your shoulders to your waist.

Vertebrae are the building blocks of your spine, and they stack one on top of each other, getting progressively larger from the cervical spine to the lumbar spine. Vertebrae help your body carry its weight efficiently, in addition to protecting the spinal cord and internal organs.

Thoracic vertebrae have a few unique characteristics, as demonstrated in the illustration below

The spinous processes are very long in the thoracic spine. They also point downwards, as opposed to cervical and lumbar spinous processes, which point more horizontally. The thoracic spinous processes may even overlap each other, and because of that, it's difficult to arch your thoracic spine very much. The long spinous processes limit movement in the thoracic spine.

The intervertebral foramen in the thoracic vertebrae are where the spinal nerve roots exits the spinal canal and go out to the rest of the body. In the thoracic spine, though, the nerve roots don't take up much room in the foramen, so that's why you're less likely to have nerve compression problems in the thoracic spine: there's more space for the nerves to travel through.

The ribs attach to the thoracic vertebrae at the costovertebral joints, another unique characteristic of thoracic vertebrae. Everybody usually has 12 pairs of ribs—one for each thoracic vertebrae. The ribs attach in two places on the vertebrae: at the costal facet, which is on the "block" part of the vertebra, and at the costotransverse facet, which is on the transverse process.

Because the thoracic vertebrae are part of the rib cage, the thoracic spine doesn't move as much as the other spinal regions.

Intervertebral Discs

In between your vertebrae, you have intervertebral discs. These act like pads or shock absorbers for your spine as it moves. Each disc is made up of a tire-like outer band called the annulus fibrosus and a gel-like inner substance called the nucleus pulposus.

The proportion of annulus fibrosus to nucleus pulposus is greatest in the thoracic intervertebral discs. So—relative to the other intervertebral discs, thoracic discs have more of the tire-like outer band. This also adds to the limited mobility of the thoracic spine. Together, the vertebrae and the discs provide a protective tunnel (the spinal canal) to house the spinal cord and spinal nerves. These nerves run down the center of the vertebrae and exit to various parts of the body, where they help you feel and move.

Muscles, Ligaments, and Tendons

Your thoracic spine has a lot of soft tissues that support it. Muscles, ligaments, and tendons help your body move: twist, lift, throw, etc. Muscles are strands of tissues that power your movement. Ligaments are the strong, flexible bands of tissue that link bones, and tendons connect muscles to bones. Muscles, ligaments, and tendons all work to control your movements so that you don't hyperextend (bend backwards too much), hyperflex (bend forwards too much), or over-twist your spine.

Symptoms of Upper Back Pain

Many cases of upper back pain are caused by muscle or soft tissue problems, such as sprain, strain, or tension. Many symptoms, then, relate to the muscles:

• stiffness
• spasm
• pain
• tightness
• tenderness when the injured area is touched

Sometimes, you can also feel upper back pain when you take a deep breath because the vertebrae (the spinal bones) in your thoracic spine are connected to the ribs. Sneezing or coughing may also be painful.

With upper back pain (or mid-back pain), you may also have pain in your shoulders and neck (cervical spine). That's because all your muscles are connected, so if it's a muscle problem causing your upper back pain, the other muscles in your shoulders and neck can be affected.

Causes of Upper Back Pain

In order to get the best, most effective treatment for your upper back pain (also known as mid-back pain), you should know what's causing it. Your doctor can help you figure that out, but here are some common causes:

• muscle or soft tissue problem: Muscles, tendons, and ligaments—the soft tissues that support the spine—can be sprained or strained by misuse or overuse. It's possible to get an upper back muscle sprain or a strain through:

1. poor posture: Sitting with a rounded back, shoulders hunched forward, can put too much stress on the back muscles. Poor posture is one of the leading causes of upper back pain because so many office workers spend their work days at the computer. It's easy to fall into bad habits of not sitting properly, especially when you're at your desk for so many hours a day.
2. improper lifting: When picking something up, you should also use good body mechanics so that you protect your spine. Not using the proper form can cause injury and pain.
3. carrying a heavy backpack: Kids are obviously more in danger of getting an upper back injury because of a backpack. An overly loaded backpack is dangerous to the spine, but so is not wearing the backpack correctly (eg, just using one strap).

• trauma/injury: Traumatic events, such as car accidents, can cause upper back pain for various reasons. It's possible to fracture a vertebra (spinal bone). Or part of your vertebra(e) can press on a spinal nerve, which can cause pain.
• other spinal conditions: Upper back pain can be a symptom associated with other spinal conditions. For example:

1. infections: A spinal epidural abscess or a paraspinal abscess can compress the spinal cord or spinal nerves in the thoracic spine, causing pain and other symptoms.
2. osteoporosis: This is a condition affecting the bones. It weakens them, making them more likely to fracture and less likely to carry your weight well. If you have osteoporosis in your thoracic spine, you may develop upper back pain. Weakened vertebrae don't support your body's weight as well, so your muscles, ligaments, and tendons have to work harder to make up for the vertebrae. That can lead to sprain, strain, or muscle fatigue.If you have a vertebral fracture or fractures because of osteoporosis, you will probably develop a rounded back—that's poor posture, which can lead to upper back pain.
3. problematic kyphosis: When looked at from the side, your spine is supposed to curve outwards in your upper back (thoracic spine) region; that curve is called kyphosis or a kyphotic curve. However, it can start to curve outward too much, and that's problematic kyphosis. Various conditions, such as osteoporosis, can cause problematic kyphosis in the thoracic spine, leading to upper back pain.
4. scoliosis: Scoliosis causes an unusual curve or curves in the spine. It can make your spine look like an "S"or a "C" when viewed from the back. If your spine is curving to the left or to the right in the upper back (thoracic spine), you may have pain because of how the curve affects spinal nerves, muscles, and other soft tissues.
5. other conditions: Upper back pain can develop in conjunction with other medical conditions not related to the spine. For example:

• acid reflux (GERD)
• ulcers
• cardiac conditions, such as angina

The upper back (thoracic spine) is much more stable than the neck (cervical spine) and low back (lumbar spine). It doesn't move as much as they do because one of its main jobs is to protect the internal organs in the chest. It does this in conjunction with the ribs, which are attached to the thoracic vertebrae.

Because the thoracic spine doesn't move as much, it's less prone to the joint and disc problems that more commonly affect the neck and low back. That doesn't mean that you can't have a herniated disc causing your upper back pain, but it is much less common.

It's also less common to have degenerative problems in the thoracic spine. The neck and low back move more, so the joints and discs may wear out sooner from use, overuse, and misuse.

Exams and Tests to Diagnose Upper Back Pain

Upper back pain can become so severe that it limits your daily life. If it gets to that point, or if your pain lasts more than a week, you should make an appointment to see a doctor.

During your visit, the doctor will ask you basic questions and perform some exams. All that will help him or her diagnose the cause of your upper back pain and develop a treatment plan for you—a way to manage your pain and other symptoms and heal your body.

Questions to Help the Doctor Understand Your Upper Back Pain

The doctor will probably ask you questions such as:

• When did you first notice the pain?
• Does the pain seem to travel from your upper back to any other part of your body?
• Have you noticed other symptoms besides pain?
• What activities did you recently do?
• What have you done to treat your upper back pain?
• Does anything reduce the pain or make it worse?

Physical Exam

The doctor will also do a physical exam. In that exam, your doctor will observe your posture, range of motion (how well and how far you can move certain joints), and physical condition, noting any movement that causes you pain. Your doctor will feel your spine, note its curvature and alignment, and feel for muscle spasms and tenderness. Upper back pain is often caused by muscle problems, so a thorough physical exam is important.

Neurological Exam

You may also have a neurological exam. The doctor will test your reflexes, muscle strength, other nerve changes, and pain spread (that is—does your pain travel from your back and into other parts of your body?). The neurological exam checks to see if your spinal nerves have been affected.

Imaging Tests

You may have to have imaging tests done if the doctor suspects that your upper back pain is caused by a mechanical problem in the thoracic spine (as opposed to a muscle problem such as a strain).

You may have an x-ray, which can help your doctor "see" the bones in your spine. X-rays are effective at showing vertebral fractures or osteoarthritis.

A Computerized Axial Tomography scan (a CT or CAT scan) is the best imaging test to show the bones and joints.

If your doctor thinks there is a nerve problem, you may have to have another test called a Magnetic Resonance Imaging test (an MRI) performed. The pictures produced by an MRI machine are very detailed, so the doctor can see all of the structures in your spine. On an MRI, the discs show up better than on a CT scan.

Other Possible Tests

Osteoporosis is a possible cause of upper back pain, so if your doctor suspects that you have that bone-weakening condition, he or she may have you do a bone mineral density (BMD) test. It will help the doctor understand how strong and healthy your bones are. For more information on how a BMD test helps doctor diagnose osteoporosis, read the article Exams and Tests for Osteoporosis.

Diagnosis

Through the physical and neurological exams—and with any needed imaging tests—the doctor should be able to diagnose the cause of your upper back pain and get you on your way to feeling better.

Read more about :  Neck pain diagnosis & treatment

Source : http://www.spineuniverse.com/conditions/back-pain/upper-back-pain/anatomy-upper-back

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Tips for keeping back healthy according to age

It’s inevitable; the clock is ticking, and we are all getting older. In 1960, the average American woman lived to age 73 with men making it just to age 66. Fortunately, American men and women are now living longer (82 for women with men lagging behind at 76) and with a longer life, many of us are trying to remain healthy and active well into our 70s, 80s and even 90s.

Among the parts of our body with the shortest “warranties” is the spine; an extraordinary collection of bones, discs and muscles that keeps us upright and moving. To maximize our chances of remaining active and mobile, as we age; we should focus on a few key preventative issues.

Tip #1: Exercise

No matter how pristine your spine is, you need a strong heart and lungs to pump out fresh blood to keep your organs moving. The American Heart Association recommends at least 30 minutes per day of moderately intense aerobic exercise 5 days per week. The inclusion of so-called weight-bearing exercise, along with calcium and vitamin D supplementation, is a critical component to combat the development of bone loss and/or osteoporosis, which can weaken the spine and put you at risk for a broken hip or a spinal fracture. In addition to weight-bearing aerobic exercise, emphasizing core strengthening during exercise (working the belly and back muscles) helps to improve posture and take some of the load on the spine; preserving the “tread on those tires!”

Tip #2: Body Weight

It’s not all about weight loss, but rather maintenance of a reasonable weight. A simple way to get a rough estimate of your “ideal” body weight is the following formula:

• 50kg (110 pounds for men) or 45kg (99 pounds for women) +2.3kg (5 pounds) for every inch in height over 5 feet.
• Try to stay within 10% of that number, and you should be in good “shape.” 

Also, remember it’s not just exercise that keeps your weight under control but what you put in your tank that matters; so watch the carbs! The combination of a strong core and not asking your spine to support more pounds than it was designed to do; is a great way to protect your back as time goes by.

Tip #3: Tobacco

Everyone knows that smoking is bad for your lungs and heart, but did you know that smoking can speed up the development of osteoporosis and make your bones more brittle? In addition, tobacco smoke has been associated with loss of the normal water in the spine's discs that can lead to the development of degenerative spinal disc disease and loss of the normal shock-absorbing properties of the spine. This in turn can lead to early spinal arthritis and loss of mobility. The bottom line; smoking is bad for your back.

Tip #4: Diabetes

As a byproduct of our nation’s obesity problem, more than 100 million Americans are either diabetic or at the prediabetic stage. If the problems that diabetes causes in the heart, nerves, brain and eyes were not enough, poor control of blood sugar or glucose (the hallmark of diabetes) has been associated with spinal arthritis (spondylosis) and back pain.

The loss of mobility seen in a patient with a painful spine can set up a vicious cycle of reduced activity and increasing weight gain, which can send blood sugar soaring. If your family doctor has put you on notice about your glucose, be aggressive in getting it under control to protect your spine.

Tip #5: The Job

For most of us, going to work is an unpleasant fact of life, but we can work to keep our job from “breaking our back.” Many of us think of those individuals that work at heavy labor as the ones putting their spines at risk, but sedentary office positions can also wreak havoc on our bones and discs. Sitting slumped in front of the computer for hours on end puts a great deal of stress and wear on our neck and low back.

• Try sitting upright in your chair, shoulders back. 
• Make sure you get up and move around every 30 minutes or so.
• Be sure the ergonomics of your workstation  are optimal.
• Your computer monitor should be at eye level. If not prop it up on a box or a few books.
• A chair with lumbar support or a pillow at the small of your back will help give you the added cushion your back needs when sitting.
• Setting your chair height so that your feet can easily reach the ground will also help relieve the strain on your spine.

Keep in Mind

Remember that age is more than a number; it is a relative state of mind. While these tips are certainly no guarantee of avoiding a “bad back”; following these simple steps and using common sense can help minimize your chances of developing spinal troubles and hopefully keep you moving easily and feeling “young” as you age.

Read more about : Back pain types

Source : http://www.spineuniverse.com/conditions/back-pain/keeping-your-back-healthy-you-age

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