Mid to Upper Back Pain: Causes and Effective Treatment Options

We’re proud to care for patients from Chandler, Mesa, Gilbert, Ahwatukee, South Phoenix, Laveen, Casa Grande, Sun Lakes, and Maricopa. One of the most common complaints we hear from older adults is mid to upper back pain. For many of these patients—especially those over 65—the cause turns out to be a compressed vertebral fracture. These fractures are more common than you might think and often require vertebral compression fracture treatment to help patients return to normal life.

What’s Causing That Upper or Middle Back Pain?

3D medical illustration of vertebral compression fracture in the thoracic spine

Compressed vertebral fractures (VCFs) occur when bones in the spine collapse or crack. This can happen when bones are weakened by conditions like osteoporosis or from injuries such as a fall or car accident. Cancer that spreads to the spine can also weaken the bones and lead to fractures. In rare cases, infections or metabolic disorders are the cause.

Common Causes Include:

Osteoporosis – Fragile bones that may break with minimal stress.
Trauma – Falls, auto accidents, or improper lifting techniques.
Cancer – Including multiple myeloma and metastatic disease.
Other conditions – Infections, inherited bone disorders, or metabolic diseases.

How Do You Know It’s a Fracture?

Symptoms often appear suddenly and may include:

Sharp, deep pain in the middle or upper back that worsens with movement
Hunched posture or visible curve in the spine
Loss of height
Difficulty standing or walking for extended periods

Getting the Right Diagnosis

We start with a physical exam and often use X-rays. However, X-rays can miss subtle or early fractures. MRI is the gold standard for diagnosis—it helps determine if the fracture is new and can rule out other serious causes like cancer.

If MRI isn’t an option, CT scans or dual-energy CT (DECT) scans offer excellent alternatives. DECT is particularly useful when MRI is contraindicated due to pacemakers or metal implants. It also detects bone marrow edema, an early indicator of acute fracture.

Diagnosing vertebral compression fractures early is crucial. Timely diagnosis can lead to faster pain relief, prevent additional fractures, and reduce long-term complications.

Doctor educating a patient about their back pain diagnosis

How Do We Treat It?

Treatment depends on the severity of your symptoms and the underlying cause of the fracture.

Our approach to vertebral compression fracture treatment includes conservative care and targeted procedures that offer long-term relief.

Conservative Care

For stable fractures with mild to moderate pain, we typically recommend:

Over-the-counter pain relievers like ibuprofen or acetaminophen
Gentle physical therapy to restore mobility and strength
Medications to strengthen bone:
- Bisphosphonates – Reduce bone loss and fracture risk
- Denosumab – Twice-yearly injections that support bone density
- Teriparatide – A daily injection that promotes new bone growth
Supportive bracing (such as a TLSO brace—learn more here)

Patients typically wear braces for several weeks, which provides support during healing. Many patients say the brace helps them feel more secure and able to move comfortably.

Minimally Invasive Procedures

For patients with severe pain or those who don’t improve with conservative care, we may recommend:

Vertebroplasty – Injecting medical cement into the fractured bone for stability
Kyphoplasty – Using a balloon to restore height before injecting cement

These procedures offer fast pain relief and improved mobility. Kyphoplasty may also help correct posture by restoring vertebral height. Most patients go home the same day and feel better within 24 to 72 hours. Both are typically performed with local anesthesia and light sedation.

Cement leakage is a rare but known risk. Our experienced team uses the latest techniques to minimize this and ensure safety.

Choosing the Right Treatment

We consider several factors when tailoring a treatment plan:

Severity and duration of your pain
Stability and location of the fracture
Imaging results (e.g., degree of vertebral collapse, marrow edema)
Presence of osteoporosis or cancer
Your general health and activity level

If scans show poor healing potential or a high risk of deformity, early interventional treatment is often recommended.

When Cancer Is Involved

When spinal fractures are caused by cancer, the goal shifts to relieving pain and preserving function. We work closely with oncologists throughout the Valley to ensure your treatment plan is safe and coordinated. Learn more about cancer pain treatment here.

Kyphoplasty and vertebroplasty can quickly reduce cancer-related back pain and restore mobility—even in palliative situations.

What to Expect in the Long Run

Osteoporotic fractures: Most patients improve within three months, but up to 40% may have ongoing pain at one year without vertebral compression fracture treatment.
Traumatic fractures: Often heal well with rest and physical therapy. Surgery is rare unless the spine is unstable.
Cancer-related fractures: Require quick intervention. Procedures like kyphoplasty can significantly improve quality of life.

With the right care, most people return to daily activities and enjoy a better quality of life.

Common Questions About Vertebral Compression Fracture Treatment

Is treatment covered by insurance? Yes. Most procedures are covered with appropriate documentation.
Do I need a referral? Not always. Give us a call, and we’ll check based on your insurance.
How soon can I return to my routine? Many patients feel better in a few days and resume light activity within a week.
Will I need repeat treatments? Usually not. Most patients need only one procedure. However, follow-up care for bone health is key.