Chronic Mid Back Pain: Muscle Spasms Second Common Symptom after Thoracic Pain

You may find the top two reported causes of mid back pain surprising

Written by Stewart G. Eidelson, MD

Mid back pain, that is pain felt in and around the thoracic spine, was self-reported by 86% (n=166 of 194) people who completed the Chronic Back Pain in America 2015 survey sponsored by SpineUniverse.com. Similar to other survey responders, these patients indicated they have been living with chronic mid pack pain for at least 3 months.
Pain was the foremost symptom of a thoracic spine condition among the 194 people who participated in this section of the survey. However, like other spinal disorders, we see their pain was accompanied by many different symptoms as summarized in Table 1, below.

Table 2 (below) summarizes where patients felt the effects of chronic mid back pain (eg, upper back).

Table 3 (below) summarizes the types of activities that patients indicated were limited symptoms related to their mid back pain. Notice that sleeping led the list.

Table 4 (below) summarizes the diagnoses survey takers self-reported. Keep in mind that mid back pain can be diagnosed as having more than one cause. There were 194 responders to this question.

Table 5 (below) indicates the types of spine specialists who diagnosed the cause(s) of chronic pain affecting the thoracic (mid back) pain experienced by the patients who participated in the Chronic Back Pain in America 2015 survey. There were 194 responders to this question; 4% (n=8) indicated they had not seen a doctor.

Nonoperative Treatments
Table 6 (below) reflects the feedback from 186 participants. Here SpineUniverse reports on different nonsurgical treatments patients used/tried to help reduce their mid back pain, and therapies that were found to be ineffective.

Who prescribed pain medications?
The majority of physicians who prescribed pain medications were pain management specialists (45%, n=62) and primary care physicians (36%, n=49). Orthopaedic surgeons (4%, n=6), neurosurgeons (4%, n=6), and physiatrists (6%, n=8) were other physician categories that prescribed pain drugs.

Surgeon Recommended Surgery to Treat Mid Back Pain
Compared to patients who received a recommendation for neck or low back/sacral surgery, the number of thoracic patients was much lower. Here, 11% (n=20 of a total of 186) reported, “ever having mid back surgery,” while 14% (n=26) indicated their doctor recommended surgery to treat chronic mid back pain. About 15% (n=4 of 26) indicated they underwent another thoracic surgery to revise a previous procedure.

Types of spine specialists who recommended thoracic surgery, included:

Table 7 (below) recaps the surgical procedures surgeons recommended. Keep in mind that a spine surgery may include more than one procedure and/or approach. There were 26 patients who responded to this question.

*A decompression procedure may include discectomy, microdiscectomy, corpectomy, foramintomy, laminectomy, laminoplasty, and/or laminoforaminotomy.

Second Opinions
Again, of the 26 patients, 39% (n=10) sought a second opinion, while 31% (n=8) did not because they trust their doctor’s recommendation. Another 31% (n=8) did not seek a second opinion for “other” reasons. Table 8 (below) details the type of spine specialist patients consulted with for a second opinion.

Which surgeon performed mid back surgery?
Revisiting the 10 survey respondents who sought a second opinion, who did they choose to perform their thoracic surgery? Almost 57% (n=15) decided against having surgery, while 36% (n=9) went with the first surgeon, and 7% (n=2) selected the second opinion surgeon.

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