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Poor posture and mid back pain are connected. There are certain postures that bring about this sort of pain. However, before we get fully into these postures, let us take a look a middle back pain.
What is middle back pain?
Middle back pain affects below the neck and above the bottom of the rib cage, in a part of the body called the thoracic spine. There are 12 backbones that make up the spine — the T1 to T12 vertebrae. Disks reside between these bones.
The spinal column gives protection to the spinal cord. The spinal cord is a long bunch of nerves that allows the brain to send messages to the rest of the body.
There are certain ways the bones, muscles, ligaments, and disks in the spine can irritate the nerves, resulting in back pain.
Symptoms of middle back pain
There are several symptoms that encompass middle back pain. Symptoms depend on the cause of the pain. The common symptoms of mid back pain include the following:
- muscle aches or pain
- sharp or stabbing pain
- muscle tightness or stiffness
- a burning sensation
- dull pain
Other serious symptoms may include:
- numbness or tingling in the legs, arms, or chest
- weakness in the legs or arms
- chest pain
- loss of bowel or bladder control
Now, we have known what middle back is and symptoms of it. Going further, we will see what causes this sort of pain. This is where poor posture really comes in.
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1. Poor posture
This any posture that one takes that brings about an abnormal effect on the body. These include bad sitting postures, standing, walking, and sleeping postures.
Poor posture results from certain muscles tightening up while others lengthen and become weak This often occurs as a result of one’s daily activities.
Here are certain poor postures and their mid back pain effects:
- Kyphosis posture
- Lordosis posture
- Flatback posture
- Swayback posture
1. Kyphosis posture
The word “kyphosis” describes a certain type of curve in the spine. A kyphotic curve is often present in the thoracic spine (spine in the chest area).
A kyphotic curve looks like the letter ‘C’ with the opening of the C pointing towards the front. Though the thoracic spine is meant to be curved, if the curve in the thoracic spine is more than 40 to 45 degrees, it is considered abnormal; a spinal deformity.
The Kyphosis structure is of different types:
- Postural Kyphosis
- Congenital Kyphosis
- Post-surgical Kyphosis
- Degenerative Kyphosis
1. Postural Kyphosis
Postural kyphosis, or “round back,” is a result of poor posture. This posture is seen mostly in adolescents and young adults. This is because they often slouch when standing and sitting. This causes the spine to curve forward.
This is often accompanied by ‘hyperlordosis’ of the lumbar (lower) spine. Hyperlordosis means that the lumbar spine compensates for the excessive thoracic kyphosis by curving more in the opposite direction.
A postural kyphosis corrects itself when the spine is hyper-extended, or when lying down on a flat surface. When viewed with X-rays, you will not see any vertebral abnormalities. This is because structural damage or deformity does not bring about this kyphosis.
In fact, to correct postural kyphosis, education about proper posture and some retraining on how to sit and stand correctly does just fine.
Treatment does not necessarily need to include bracing, casting or exercise. However, ensuring that the back muscles get stronger can help with proper posture.
This posture, when maintained over a long period of time, leads to midback pain in individuals.
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2. Congenital Kyphosis
This posture, Congenital kyphosis refers to abnormal development of the spine. It is inherited. This means a person is born with some sort of defect, like the incomplete formation of the spine. Consequently, it can lead to severe abnormal kyphosis.
This type of poor posture is often corrected by surgical treatment.
This poor often causes midback pain in individuals with this postural fault.
3. Post-Surgical Kyphosis
Kyphosis can come to be after surgery of the spine for the correction of other problems. This often happens when the surgery performed does not heal as expected. For instance, a spine fusion may not heal. This unstable fusion is likely to cause the spine to fall into a kyphosis. The ligaments of the spine are likely not to heal strong enough to support the vertebrae and allow the spine to form a kyphotic curve. A second operation may be required to try to correct the problem.
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4. Degenerative Kyphosis
There are also cases where kyphosis is caused by degeneration. This means wear and tear of the lumbar (lower) spine. As time goes on, the degenerative process can bring about: changes in the shape of the vertebrae, the collapse of the intervertebral disc, and weakening of the ligaments that support the spine.
Kyphosis can also be as a result of :
- Paralytic Disorders
- Post-traumatic causes
Other Causes of Kyphosis
Systemic diseases can cause a kyphosis to develop over a period of time.
These conditions include: cancer or tumors that involve the spine, infection in the spine and different types of systemic arthritis.
Any of these kyphosis postures can result in mid back pain if not attended to.
2. Lordosis Posture
Lordosis is a curve that naturally occurs at the lower back (lumbar) area of the spine. With an extreme curve, the lower spine will have a deep curve, causing the abdomen (stomach area) to stick out and causing the pelvis (hip areas) to curve back and up. These extreme curves can be brought on from bad posture, family genetics (passed from father or mother), injury, illnesses of the spine, or surgery to the spine
Types of Lordosis
1. Postural Lordosis
This often comes from being over-weight. It also comes from a lack of muscle conditioning in the stomach and back muscles. When a person has too much weight in the front (stomach area), it causes the back to pull forward. When the stomach and back muscles are weak, supporting the spine becomes a problem. The pull from the weight causes the spine to curve forward.
2. Congenital Lordosis
A trauma/injury to the connecting links of the spine (pars) can cause them to break (fracture) causing pain in the low spine. In children, these often occur from sports injuries. This can also be seen in children hit by a car or with falls from high areas.
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There can also be a defect in the way these links develop with growth, causing them to be misshaped and weak. With repetitive activities stressing these weak links, they can develop a spondylolysis (break in bone connection).
Whatever the reason the break occurs it needs rest and restricted movement to heal. If not, over time, the vertebrae (spine blocks) can slip forward and pinch nerves in the spine. This can lead to pain, numbness, tingling, weakness, and dysfunction of the legs.
3. Post-surgical Laminectomy Hyperlordosis
A laminectomy is a surgical procedure where parts of the vertebrae (spinal bones) are removed to give access to the spinal cord or nerve roots. When this is done over several levels in the spine, it can cause the spine to be unstable and increase the normal curve to a hyperlordotic (overly curved) position. This is not a common problem in adults and more routinely is seen occurring in children with spinal cord tumors following surgery to remove the tumor.
4. Neuromuscular Lordosis
This group includes a large variety of conditions/disorders that can lead to many different types of spinal curvature problems. For each different disorder, there are different treatment options.
5. Lordosis Secondary to Hip Flexion Contracture
This is a unique group of patients who develop a contracture of the hip joints causing the spine to be pulled out of alignment. This contracture can come from a variety of reasons including infection, injury, or muscle imbalance issues from several different disorders.
Symptoms of Lordosis include:
- numbness
- tingling
- electric shock pains
- weak bladder control
- weakness
- difficulty maintaining muscle control
3. Flatback posture
The flat back or C shaped posture is identified by a forward head and a hunched upper and lower back to form a distinct C-shaped curve. Many of us who slouch would most likely have this posture.
Why does it happen?
This is a result of a weak erector spinae, which is a group of muscles that moves vertically to prop you upright. Being in this C shaped posture persistently overstretches the erector spinae, thereby increasing load on the discs — our natural shock absorbers and protective pads for our vertebrae. Other structures in the area, such as the ligaments are also stretched, causing lower and middle back pain, and is worse cases, disc herniation.
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Who has this posture?
Habitual slouchers and exceptionally tall people who would usually have a tendency to hunch over their desks, look downwards at standard height objects.
What makes it worse?
Stress points that aggravate the flat back posture can include hunching over a computer or laptop at a desk or generally, long hours of sitting incorrectly.
Don’ts to prevent flat back posture
- Perform certain exercises such as cycle, rowing, or squats that round the back.
- Bend down using your back. Activate your thighs instead!
- Sleep on a soft bed or sit on a soft-cushioned sofa, which provides no support.
Do’s to prevent flat back posture
- Swim the breaststroke. It extends the back to counter the rounded posture.
- Yoga poses such as the Superman, Cobra or Upward Dog to arch your back.
- Use back support accessories, and sit fully against the backrest. Use a footstool to prop your feet at a 90-degree angle, if you have to.
Swayback posture
The swayback posture is casually known as the ‘lazy posture.’ It is identified by shoulders and chest leaning backward, with hips turned in and pelvis and chin thrust forward.
Why does it happen?
This posture is usually due to a lack of support for the hips and pelvis, hinging at the back, thereby applying immense pressure on the lower back, leading to pain. Weak abdominal muscles also contribute to the problem, as these muscles function to bring the upper body forward.
Who has this posture?
Those with weak buttocks, quads and lower abdominal muscles; people who adopt this posture often find themselves needing additional external support, such as a wall or other grounded objects to lean against. The swayback posture is almost the antithesis to the flat back posture.
Why does this posture cause back pain?
Like the arched back posture, the swayback posture is also an extension, albeit a more severe one as it overstretched the back and pelvis. So similarly, the forward shear force worsens the extension of the lower back. Additionally, this posture will lead to excessive compression and even degeneration in the joints, which causes pain and instability.
Don’ts to prevent swayback posture
- Stand hanging off your hips and spine. Stand up tall using your muscles.
- Swim breaststroke or practice yoga poses like Superman, Cobra or Upward Dog.
- Use back support accessories with an arched shape.
Dos to prevent swayback posture
- Sit deep in your chair, with your back straight and your chin facing ahead.
- Train your butt and quad muscles (see image below) with the correct exercises, such as half squats.
- Strengthen your lower abdominal muscles with leg lifts and reverse crunches.
Other things that could cause mid-back pain besides poor posture, include
2. Obesity
3. Muscle sprain or strain
4. Fall or other injuries
5. Herniated disk
6. Osteoarthritis
7. Aging
8. Fractures
These are some of the major causes of mid back pain. However, practicing proper posture from the start will keep mid back pain away.
