Upper Back Pain

What is upper back pain?

Upper back pain affects your back anywhere from the base of your neck to the bottom of your rib cage (thorax). This segment is also called your thoracic spine. Your middle back is technically part of your thoracic spine, too.

Your upper back is mainly for structure and support. It doesn’t move and flex as much as your neck (cervical spine) or your lower back (lumbar spine). But upper back pain is still common. And sometimes, it comes from conditions inside your body.

What does upper back pain feel like?

Upper back pain can feel different depending on the cause. Some words to describe it include:

• Sharp or dull
• Throbbing or twisting
• Aching or burning
• Radiating or spreading
• Tingling or pins and needles

Try to keep tabs on the following details about your pain:

• Where it happens
• When it happens
• Other symptoms, like muscle spasms, that happen with it
• How severe it is, and whether that changes over time
• What (if anything) makes it feel better
• If you’ve had it for 12 weeks or more (that’s known as chronic back pain)

Writing down notes about your pain as it happens can help you explain it to your provider. All those details can be valuable clues to a provider making a diagnosis.

What are the most common causes of upper back pain?

Upper back pain usually happens because of something going on in your back. But it can also happen because of what’s happening deeper inside your body. Some examples include:

• Age-related diseases like osteoporosis and osteoarthritis
• Bone and joint injuries affecting the rear segments of your ribs or your shoulders and shoulder blades (because they anchor to your back)
• Congenital conditions like spina bifida
• Connective tissue disorders like Marfan syndrome or Ehlers-Danlos syndrome
• Inflammatory diseases like ankylosing spondylitis or rheumatoid arthritis
• Job-related repetitive strain injuries, which can affect workers in blue- and white-collar jobs
• Soft tissue injuries, like sprains and strains
• Spinal cord and nerve injuries, such as spinal cord compression or pinched nerves
• Spine curve conditions, like scoliosis or kyphosis
• Spine injuries or damage, like herniated disks or fractured vertebrae
• Strain and posture-related injuries from sports, hobbies or other regular activities

Referred pain

Upper back pain can sometimes happen because of referred pain. That’s where pain in one body part relates to something going on in another part. It happens when your brain mistakenly interprets pain as coming from somewhere else connected to the same branch of nerves.

Referred pain in your back can come from organs inside your body. Those include your:

• Esophagus: A spasm or pain in your esophagus can feel like a twisting pain right between your shoulder blades.
• Heart: Angina from your heart can feel like pain in your back.
• Kidneys: This is why kidney conditions often feel like back pain. Kidney pain usually affects your lower back, but can sometimes also affect the bottom of your upper back.
• Lungs: Conditions like pleurisy can cause back pain when you breathe. While it’s not common, back pain can also be a sign of lung cancer.
• Spleen: A sudden, sharp pain between your shoulder blades can signal a ruptured spleen.

Referred back pain can come on quickly or slowly. And it usually happens without an injury you can tie it to.

This kind of pain is an emergency when it also happens with certain symptoms. These include trouble breathing, chest pain or any other symptoms that could mean a heart attack or pulmonary embolism. Call 911 (or your local emergency services number) immediately if this happens to you or someone you’re with.

How is this symptom treated?

The treatment for upper back pain depends mainly on the cause, how serious that cause is, your health history and whether it could be an emergency. In many cases, upper back pain can go away on its own as long as you rest. Your healthcare provider can tell you more about what to expect in your case.

When upper back pain isn’t an emergency, your provider might recommend treatments like:

• Cold or heat packs
• Complementary therapies, like acupuncture or massage therapy
• Ergonomic changes to prevent further damage from repetitive strain injuries
• Over-the-counter pain relievers like acetaminophen, or NSAIDs like ibuprofen or naproxen
• Pain management techniques like nerve blocks or botulinum toxin A (Botox®) injections
• Prescription anti-inflammatory medicines or muscle relaxers
• Physical therapy to improve strength and posture
• Rest

What are the possible complications or risks of not treating upper back pain?

While it’s often not serious, upper back pain can still have a big impact on your life. Pain can make it hard to work, enjoy hobbies, do errands or chores around the house, and just go about your usual routine.

When the cause is more severe, not treating upper back pain can lead to serious or even life-threatening complications. If you have questions about possible complications from your upper back pain, talk to your healthcare provider. They can help you understand what to expect and how you can help yourself.

Can upper back pain be prevented?

Many of the causes of upper back pain aren’t preventable. But you can reduce the odds of some causes happening. Steps you can take include:

• Be cautious when lifting: Safe lifting practices can protect your back from harm.
• Use ergonomics: They can keep repeated small strains from adding up and hurting your back.
• Stay active: Physical strength and flexibility are both important to your back health.
• Make posture a priority: How you sit, stand and lie down can help you avoid back pain.

There may be other steps you can take that might help. Your healthcare provider is the best person to ask for information tailored to your life.

When should upper back pain be treated by a healthcare provider?

Upper back pain needs professional medical care when:

• It doesn’t get better after a week
• You develop any tingling or numbness in your butt, legs or feet
• You have a fever or unexplained weight loss

Get medical attention immediately if you have any symptoms that could come from a heart attack or pulmonary embolism. You also need emergency care if you have symptoms of nerve or spinal cord issues, like cauda equina syndrome. These include:

• Muscle weakness or paralysis in one or both legs
• Loss of control causing you to pee or poop yourself
• Inability to pee, even if you’re hydrated