The upper back is usually more resistant to pain and injury, compared to your neck and lower back. If you have pain in your upper back, it’s often because of bad posture over a long time or an injury that’s stronger than the upper back’s usual strength.
Upper back pain can happen anywhere from the bottom of your neck to the top of your ribcage. It might be from injuries, bad posture, disk issues, or other problems like arthritis. If your upper back pain is not too severe, you can often take care of it at home.
This article looks into different signs of upper back pain, what might be causing it, and modern ways to figure out and treat the problem.
Table of Contents
What is Upper Back Pain?
Upper back pain happens between the base of your neck and the bottom of your rib cage. This area is called the thoracic spine, made up of 12 small bones called vertebrae. These vertebrae create your backbone.
Each vertebra in your thoracic spine is linked to a pair of ribs that wrap around your body to a flat bone in the center of your chest called the sternum. Together, they form your rib cage.
In your upper back, there are disks between each vertebra that absorb shock when you move. Muscles and ligaments also play a role, holding your spine together. Various issues or injuries to the bones, disks, muscles, and ligaments in your upper back can cause upper back pain.
Unlike neck or low back pain, upper back pain is less common. This is because the bones in the upper back don’t move or bend as much as those in the neck and lower back. The bones in the upper back, along with the ribs, work together to keep the back stable and protect vital organs like the heart and lungs.
Read more: Different Types of Back Pain
Causes
Upper back pain can stem from various sources, and sometimes the cause is unclear, leading to what’s called non-specific back pain. This often happens when the muscles and soft tissues in your back get irritated.
One common reason for upper back pain is maintaining poor posture over an extended period. Good posture involves standing tall and straight with your shoulders back and down, keeping your head level and avoiding tilting. Ensure that your ears, shoulders, hips, and ankles align in one straight line.
Additional causes of upper back pain include:
Accidents or Sudden Injuries: Such as whiplash from a car accident or injuries during sports activities.
Straining Muscles or Ligaments: Resulting from overexertion or lifting heavy objects improperly.
Muscle Weakness: Not engaging in regular exercise can lead to insufficient strength in your back muscles.
Prolonged Computer Use: Sitting at a computer for long periods can strain your upper back.
Carrying a Backpack: The weight and strain from carrying a heavy backpack can contribute to pain.
Repetitive Movements: Certain activities that involve repetitive motions may cause overuse injuries.
In some cases, more severe conditions may lead to upper back pain, including:
Osteoporosis: A condition where bones become brittle and fragile.
Osteoarthritis: The degeneration of joint cartilage and the underlying bone.
Spinal Stenosis: Narrowing of the spinal canal, putting pressure on nerves.
Slipped Disc: Occurs when a disc between spinal vertebrae moves out of position (though this rarely causes upper back symptoms).
Ankylosing Spondylitis: A type of arthritis affecting the spine.
Symptoms
Upper back pain can differ from person to person, and its intensity varies based on the underlying cause. The pain might be mild or more intense, occurring as a sharp sensation in a specific area or a general achiness that comes and goes. When the cause of back pain isn’t clear, it’s referred to as non-specific back pain.
People express upper back pain in various ways. It can feel like:
- A burning or sharp pain.
- An achy, throbbing pain.
- Muscle tightness or stiffness.
- Pain spreading along a nerve.
- Tingling, numbness, or weakness.
Diagnosis
When you tell your doctor about your upper back pain, they’ll ask you how it feels and give you a checkup. Sometimes, they can figure out the cause right then. Other times, they might suggest some tests to be sure. Usually, upper back pain comes from strained muscles, but occasionally, it could be more serious. Your doctor will watch out for certain signs, often called red flags, that might point to a more serious issue. These include:
- Recent big bumps, like a car crash or a fall
- Back pain from a minor injury or lifting something heavy, especially if you have osteoporosis
- A history of cancer or a weakened immune system
- Extra symptoms like a fever, unexplained weight loss, and chills
- A recent bacterial infection
- If you’re younger than 20 or older than 50
Your doctor will also ask you more about the pain to understand how bad it is and what might be causing it. They’ll be especially cautious if:
- The pain hasn’t improved even after changing positions or resting
- You’ve had the pain for more than two weeks, despite trying treatments
- The pain doesn’t seem like a regular sprain or strain in your upper back
- You wake up really stiff in the morning
- The pain is constant and getting worse
Your doctor might ask if you’ve noticed any weakness in your legs or if you’re having problems with your bladder and bowels, like not being able to control them. These could be signs that nerves in your spine or spinal cord are under pressure, possibly from a slipped disc or injury.
If there’s another issue with your lungs, esophagus, stomach, pancreas, liver, or gallbladder, you might feel pain in your upper back. This is called referred pain, where a problem in one place causes pain somewhere else.
Depending on what your symptoms are and what the doctor finds, they might send you for more tests. These could include blood tests, X-rays, and an MRI scan (a special test that uses magnets and radio waves to make pictures of the inside of your body). You might also get a DEXA scan, which checks how strong your bones are.
How is Upper Back Pain Managed or Treated?
If your upper back hurts, what you do to help depends on what’s causing it. If it’s not too bad, you can usually make it feel better on your own. Here’s what you can try:
Medications: Over-the-counter pain medications like acetaminophen (Tylenol®) and nonsteroidal anti-inflammatory drugs (NSAIDs) can provide relief from pain and inflammation.
Heat therapy: Applying a heating pad to the affected area can help reduce pain and stiffness by increasing blood flow and promoting muscle relaxation.
Cold therapy: Using an ice pack wrapped in a cloth can help reduce pain and swelling, particularly in cases of acute injury or inflammation.
Medical massage: Professional massages targeted at the upper back can help relax tense muscles, alleviate pain, and improve circulation.
Rest: Make sure you get enough rest for your body to heal and recover. Of course, it’s important strike a balance between rest and gentle movement to avoid prolonged immobility.
How to Prevent or Relieve Upper Back Pain at Home?
You’ve got options to prevent or ease upper back pain at home. Here are some simple things you can do:
- Gentle Exercise: Move around to stretch and make your upper back muscles stronger.
- Good posture: Stand and sit up straight. No slouching allowed!
- Reduce Stress: Relax with deep breathing, calming exercises, or meditation to lower stress.
- Quit Smoking: Smoking speeds up disc degeneration, those shock absorbers between your vertebrae.
- Drop Extra Weight: If you’re overweight, shedding pounds can lower your risk of back pain.
- Sleep Well: If you wake up achy, consider a mattress that supports your back’s curves.
When to See a Doctor
Most upper back pain gets better by itself. You might need to call your healthcare provider if:
- Your upper back pain doesn’t get better in a week.
- You start feeling tingling or numbness in your legs or buttocks.
- You have really bad pain or muscle spasms.
- New symptoms pop up, like fever, weight loss, or issues with your bowels or bladder.
These signs could mean something more serious is going on. It’s good to get them checked out.
Sophia Anderson, PT, DPT is a physical therapist who offers online pain management consultations. She helps people with various types of pain, especially neck, back, and knee pain.
She graduated from the University of St. Augustine with a Doctor of Physical Therapy (DPT) degree. She has experience in orthopedic physical therapy, sports medicine, neurological rehabilitation, advanced assessment and treatment of running injuries, and advanced treatment of the pelvic complex, spine, and extremities.
If you’re experiencing any pain, let Sophia Anderson, PT, DPT help you out.