Question
Dear Doctor,

I am 46 year old woman weighing 50 kg approx , I work as a teacher for the primary class students- I have occasional pain which arises at the upper back. Then the pain usually across the thoracic region towards my breasts and the midriff in the upper thoracic  area . if pain is greater sometime it would move to the neck region. Sometime a local massage of the upper back would help relieve the pain. but sometime the massage does not give me any relief. The pain is a continuous sharp pain  which may last for 5-20 minutes and it have gone to 30 minutes.

I am normal with my food in take or with other issues related to health. I had a fall when I was in my early 20s and have had bouts of backache but eventually it is rare occurrence.  

I would like to know the underlying cause for this pain - what is  pain classified as . Would like to receive a reply to this and like to know the tests required to diagnose the issues. Or how can I relieve the pain.

Thanks and Regards

Lalitha

Answer
Dear Lalitha,

You have a very common situation.   Please understand, that while it is not possible to definitively diagnose your condition with a simple internet exchange, I'll do my best to help you understand your condition.   First, the fact that you do not mention numbness, tingling, or radiating pain into the shoulder blade, or down the arm into the hand makes your condition much more benign in nature.   It points away from such things as lung tumors, herniated spinal discs, or "thoracic outlet syndrome."   (feel free to google that one).   You simply have neck and upper back pain.   Almost always, it comes from the musculoskeletal structures of your spine and surrounding tissues.   For some women with large breasts, they have mechanical stress in these regions and the postural strain causes them to have pain.    If this is not an issue for you, then consider that you might have joints in the neck or upper back that are stuck, stiff, lack their normal movement, and thus become painful, generating pain in the regions you describe.    If you do not have pain in the middle of the night that abruptly jolts you from sleep, then we don't have to worry about things like cancer of the bones.    You might have mild arthritic degenerative changes to the spine, being in your 40's, and if so, this doesn't help, but it also is not always a source of pain.   If you do have degenerative joint disease, also called osteoarthritis or osteoarthrosis (more correctly), then it is inherited in most cases.   You'd have to recall if your parents or siblings have problems with osteoarthritis (OA), or if anyone had a hip or knee total joint replacement surgery, to have clue about whether you might be someone with this condition.    Regardless of whether you have OA or not, manual treatment would be a good place to start, especially since you sometimes get relief with massage.   A good hands-on physical examination by a chiropractor would help locate stuck vertebrae, tight or adhered tissues surrounding the joints, taught and tender fibers in the muscles, or adhesions, and he/she could use the combination of deep soft tissue release therapies in combination with joint manipulation procedures to get your joints moving better.   Joints that move better tend to feel better.   If your joints are stuck, then no amount of massage or exerciese or hot packs or medicines will alleviate it.   Chiropractic joint manipulation is your best bet.     

I hope this was helpful.

"Dr. G"