Middle Back Pain – Deformities

Middle back pain due to spinal deformities is a common occurrence among teenagers. The deformity originates since birth or during bony growth of the vertebrae. However, the symptoms are not obvious until completion of growth. If parents are watchful towards their child’s growth, it is possible to identify these abnormalities at an early age. Early diagnosis¬† and institution of corrective measures prevents their progression. Apart from back pain, they also have some serious consequences, like paralysis or breathing disorders in future. Thus, with a growing child, one should always keep an eye for the signs of these diseases.

What are deformities ?

Deformities of back are abnormal developments of the back bones, which are called vertebrae. These bones are stacked together to form the vertebral column. Hence, improper growth of a single vertebra changes the alignment of neighboring vertebrae. These changes occur over a period of months to years during the growth of the child, and cause the vertebral column to become curved sideways (scoliosis) or backwards (kyphosis). The primary abnormality in the single or a group of vertebrae is a birth defect and may also run in families.

A deformity of the back may also arise from tumors and infections of a vertebra. This can occur in any age group and its progression is dependent on the course of the tumor or infection and the type of treatment taken for it. Such deformities are termed as secondary and are either due to negligence of the affected person or the treating physician. The development of a deformity in a person undergoing treatment clearly reflects the incompetence of the treating physician in managing such diseases, and warrants a change of treatment or doctor !

Types of Spinal Deformities

Kyphosis or hump back (Picture 1) is a deformity in which a person appears to be stooping while standing or walking. It can occur because of destruction or improper development of a single or a group of adjacent vertebrae.

Picture 1: Kyphosis

(Source: Chest of Books)

The stooping puts tremendous strain on the back muscles, which have to constantly remain in tension to support the bent upper back. This muscular strain is the cause of middle back pain in kyphosis. If kyphosis is secondary, then the primary disease (tumor or infection) can give rise to bone pain at a specific point, which is worse at night. This pain is excruciating and commonly does not respond to routine analgesics. In the absence of treatment, this may proceed to complete paralysis of both lower limbs due to pressure on the spinal cord. Thus, prompt treatment is a must !

Scoliosis is a disease in which the back bones curve sideways (Picture 2). This is due to absence or destruction of a part of a vertebra, which leads to rotation and bending of the neighboring vertebra. This causes the vertebral column to become s-shaped. Each vertebra in the chest region gives rise to a rib on both sides. These changes also cause deformities in the ribcage, leading to an obstruction in chest function and breathing disorders. The severity of this deformity is measured on x-ray in terms of Cobb’s angle. The higher the angle the more severe is the disease.

Picture 2: Scoliosis

(Source: Chest of Books)

The s-shaped vertebral column leaves less space for the outgoing nerves as well as the spinal cord. Compression of these structures gives rise to shooting pain in the middle back. The muscles of the back are exposed to abnormal forces which put them under strain giving rise to muscular pains. With completion of growth the progression of scoliosis comes to a halt, but the improper functioning of ribcage and back muscles continues to worsen leading to persistent middle back pain and breathing difficulties after a few years.

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About Dr Gauresh (69 Articles)
An orthopedic surgeon trained in JJ Group of Hospitals and Grant Medical College. I have worked in this field for the past 3 years and have significant clinical experience to guide students and patients on any topic in orthopedics.

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