Mid back pain
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Mid Back Pain: Incidence, Risk Factors, and Prognosis
Incidence and Prevalence of Mid Back Pain
Mid back pain (MBP) is a common condition that affects individuals across various age groups. A systematic review highlighted that MBP is prevalent early in life and impacts quality of life similarly to neck and low back pain1. In a study of Finnish men aged 35 to 70, the 1-year prevalence of MBP was found to be 17%, which is significantly lower compared to neck pain (64%) and low back pain (66.8%)3. This suggests that while MBP is less common than other types of back pain, it still represents a significant health issue.
Risk Factors for Mid Back Pain
Physical Risk Factors in Adolescents
Adolescents are not immune to MBP, and physical factors play a crucial role. A systematic review identified that certain postural alignments, such as increased lumbar lordosis in sitting and sway-back posture in standing, are associated with MBP in adolescents2. These findings underscore the importance of maintaining proper posture to mitigate the risk of developing MBP during adolescence.
Structural and Degenerative Factors in Adults
In adults, structural abnormalities detected through imaging, such as posterior osteophytes and anterior bulging, have been associated with severe MBP6. Additionally, the presence of comorbidities and other musculoskeletal symptoms further increases the likelihood of experiencing severe MBP6. These insights suggest that both anatomical and health status factors contribute to the risk of MBP.
Prognosis and Trajectories of Mid Back Pain
The prognosis of MBP can vary significantly. A prospective observational study identified two distinct trajectories for MBP patients undergoing chiropractic treatment: a favorable trajectory with rapid improvement and a less favorable trajectory with persistent moderate to severe pain10. Chronic pain duration at baseline was a significant predictor of an unfavorable outcome, indicating that early intervention may be crucial for better long-term results10.
Age-Related Trends in Mid Back Pain
Contrary to common belief, the prevalence of back pain, including MBP, does not necessarily increase with age. A systematic literature review found no significant increase in the prevalence of back pain in the elderly population compared to middle-aged individuals4. In fact, some studies reported a decline in back pain prevalence among the oldest age groups4. This suggests that age alone is not a definitive risk factor for MBP.
Clinical Implications and Conclusion
MBP is a prevalent condition with significant implications for quality of life. Understanding the risk factors, such as postural issues in adolescents and structural abnormalities in adults, can help in developing targeted prevention and treatment strategies. The prognosis of MBP varies, with chronic pain duration being a key predictor of long-term outcomes. Contrary to popular belief, MBP does not necessarily become more common with age. These insights highlight the need for early intervention and tailored treatment approaches to manage MBP effectively.
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Most relevant research papers on this topic
Incidence and prognosis of mid‐back pain in the general population: A systematic review
Mid-back pain is common in early life and affects quality of life similarly to neck and low back pain, but research on its incidence and prognosis is scarce.
Systematic ReviewPhysical risk factors for adolescent neck and mid back pain: a systematic review
Sagittal alignment in sitting and standing postures may be potential risk factors for adolescent neck and mid back pain.
Systematic Review
Rigorous JournalPrevalence and Characteristics of Upper or Mid-Back Pain in Finnish Men
Mid-back pain is approximately one fourth as prevalent as neck and low back pain in Finnish men, with less disability and nearly always spinal comorbidity.
Observational StudyDoes back and neck pain become more common as you get older? A systematic literature review
Back pain does not increase with age, but may decline in the oldest individuals.
Systematic ReviewRigorous JournalMid-back pain due to a penetrating atherosclerotic aortic ulcer: do not miss the diagnosis-a case report.
A penetrating atherosclerotic aortic ulcer can cause mid-back or chest pain, and early diagnosis is crucial for effective treatment.
Case ReportRisk Indicators for Severe Upper or Mid Back Pain in Men
MRI degenerative findings are modestly associated with severe upper or mid back pain reporting, while comorbidities are consistently associated with all back pain outcomes.
Observational Study
Very Rigorous JournalMultidisciplinary biopsychosocial rehabilitation for chronic low back pain: the need to present minimal important differences units in meta-analyses
Multidisciplinary biopsychosocial rehabilitation (MBR) is highly recommended for reducing pain in the short- and medium-term for chronic low back pain, but cannot be recommended for long-term pain reduction due to rapid benefit decay.
Meta-AnalysisEstimating minimally important differences for the PROMIS pain interference scales: results from 3 randomized clinical trials
Minimally important differences (MIDs) for PROMIS pain interference scales range from 2 to 3 T-score points for pain samples and 3.5 to 4.5 T-score points for nonpain samples, improving their interpretability in research and clinical care.
RCT
Large Human TrialRigorous Journal
Highly CitedMinimally important differences for Patient Reported Outcomes Measurement Information System pain interference for individuals with back pain
A change of 3.5 to 5.5 points in PROMIS-PI pain interference scores for individuals with low back pain can be considered meaningful.
Rigorous JournalHighly CitedA prospective observational study on trajectories and prognostic factors of mid back pain
Two distinct mid back pain trajectories were identified, with chronic pain duration at baseline significantly predicting less favorable outcomes.
Observational StudyVery Rigorous Journal