13 Causes of Upper Back Pain
And Treatment Options
Medically reviewed by Amy Kwan, PT, DPT
Causes of upper back pain include trauma, poor posture, and degenerative diseases. While mild symptoms may be handled with home care, severe upper back pain requires a visit to your healthcare provider. Upper back pain that doesn't improve can make normal movements and daily tasks hard to manage.
This article discusses the symptoms and common causes of upper back pain. It also covers treatments and when to consult a healthcare provider for care.
Upper back pain can be a sign of a medical emergency. Call 911 or go to the emergency room if you have back pain with any of the following symptoms:
Sudden loss of feeling in one or both legs, your groin and genital area, and/or anal region
Inability to walk or stand
Problems urinating or controlling bladder or bowel movements
Back pain that radiates to your abdomen
Sudden, unbearable pain in your legs and/or lower back
Back pain after a sports injury, fall, or auto accident
Acute back pain with diagnosed osteoporosis or other known risk factors for a fracture
Loss of consciousness
Health Conditions That Can Cause Upper Back Pain
There are many causes of upper back pain. The following conditions can cause this problem (in no particular order).
Back strain occurs when you tear or overstretch a muscle or tendon fiber that moves or supports your spine. Lifting heavy objects is a common cause of back strains.
Neck or Back Sprain
A neck or back sprain is a soft tissue injury to the ligaments around a joint. It can be caused by wear and tear or a sudden injury to your back or neck, like whiplash.
Traumatic fractures occur when an injury causes breaks in your spine.
Thoracic spondylosis, or thoracic spine degeneration, can occur due to wear-and-tear conditions like thoracic osteoarthritis and thoracic degenerative disc disease.
Poor Posture Causing Upper Back Pain
Poor posture results in a misaligned spine, which can increase your risk of sprains and strains.
Degenerative Disc Disease
Degenerative disc disease is a condition in which your spinal discs wear down. It can cause a pinched nerve or herniation, a bulging of a disc that places pressure on a spinal nerve.
Spinal Compression Fractures
Spinal compression fractures occur when one or more vertebrae collapse due to too much stress. Osteoporosis is a common cause of compression fractures.
Congenital or acquired spinal deformities can cause severe curvature in the thoracic spine. Conditions like scoliosis (curved spine) or kyphosis (forward head posture) can strain back muscles and spinal discs abnormally.
Forms of arthritis that affect the spine, including osteoarthritis and ankylosing spondylitis, can cause upper back pain.
Spinal stenosis causes your spinal canal to narrow, compressing your spinal cord and/or nerve roots. This results in pain and numbness.
Tumors that occur with spinal cancer or cancers in other sites that spread to the spine can cause upper back pain.
Diseases in Some Organs
Other medical problems like gallstones (hard deposits in your gallbladder), kidney stones (hard deposits in your kidneys), or pancreatitis (inflammation of your pancreas) can cause upper back pain.
As the fetus grows, it shifts the center of the pregnant parent's gravity forward, making it hard for a pregnant person to maintain proper posture.
Learn More:The Causes and Treatment of Thoracic Spine Pain
Your healthcare provider can use a wide range of tests to diagnose the cause of your upper back pain. The types of tests you receive depend on the location and severity of the upper back pain you experience.
The following commonly used diagnostic tools are can help determine the cause of your upper back pain:
Detailed medical and family history
Questions about the location, duration, and severity of your upper back pain
Physical examination of your spine and posture
Testing your muscle strength, reflexes, and sensation
Blood tests to identify a suspected inflammatory or medical disorder
X-rays to examine your bones, and identify broken bones, changes in your spinal alignment, and changes due to aging
Magnetic resonance imaging (MRI) or computed tomography (CT) scans to view the health of your spinal canal and the surrounding soft tissues
Bone scans that use small amounts of radioactive materials to help your healthcare provider see details of your spine
Electrophysiological tests, like electromyography (EMG), which identifies problems in your muscles and nerves by measuring the electrical activity in your muscles
How to Treat Upper Back Pain
There is a wide range of options for treating upper back pain. The type of treatment you receive depends on the cause of your upper back pain.
Common treatments for upper back pain include items in the following list.
Topical (on the skin) over-the-counter (OTC) pain relievers like lidocaine
Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as the OTC medications Advil or Motrin (ibuprofen) and Aleve (naproxen)
Muscle relaxants for relief of chronic back pain from muscle tension
Spinal injections that use a numbing medication for certain types of back pain that radiates or travels due to irritation or compression of a nerve
Prescription pain relievers for severe acute back pain
Cold packs to relieve back pain
Hot packs to increase blood flow and promote healing of back muscles and tissues
Physical therapy and/or strengthening exercises to strengthen our back muscles
Gradual increase of physical activity as tolerance increases
Use of proper techniques when heavy lifting, pulling, or pushing
Spinal manipulation to adjust your spine and muscles
Acupuncture, an alternative treatment that uses thin needles to relieve pain
Laminectomy to treat spinal stenosis (narrowing of the spinal canal) by removing bone spurs and tissues exerting pressure on the nerves
Discectomy and microdiscectomy to remove part of a herniated (bulging) disc to relieve pressure on a nerve root or the spinal canal
Spinal fusion to remove a damaged disc between two vertebrae in your spine and joining the bones permanently
Disc replacement surgery to permanently replace a damaged disc with a synthetic disc
Laser spine surgery to reduce the size of a damaged disc to relieve pressure on your back nerves
Radiofrequency lesioning to block the input of pain signals from entering the spinal cord
Complications and Risk Factors With Upper Back Pain
Without treatment, your upper back pain can worsen and threaten complications. Common complications of upper back pain can include the following conditions:
Loss of productivity: Back pain is a leading cause of disability in working adults.
Nerve damage: A herniated disc can exert pressure on the spinal nerves and cause problems like weakness, numbness, or severe shooting pain
Weight gain: Restricted or painful movement can limit your ability to exercise, resulting in weight gain and loss of muscle strength.
Depression: Any type of pain, including upper back and neck pain, can increase your risk of depression and anxiety due to disrupting normal activities.
Having one or more of the following factors can contribute to upper back pain:
Age: Some causes of upper back pain can become more common with age.
Excess weight: Carrying extra body weight or having obesity exerts stress on your back and increases your risk of pain.
Poor fitness level: People not physically fit may have weak muscles that can't properly support their spine.
Genetics: Some causes of upper back pain, like osteoarthritis, increase if you have a family history of the disease.
Physically demanding jobs: Occupations that require heavy lifting, extended periods of sitting or standing, or other types of physical exertion can stress weak back muscles.
Smoking: Smoking can restrict oxygen and blood flow to your discs, promoting degeneration.
Mental health: Depression, anxiety, and mood can affect your perception of yourself and cause muscle tension.
When to See a Healthcare Provider
You should see a healthcare provider if you experience upper back pain that worsens or does not improve within two weeks of its start. Having back pain with any of the following symptoms also indicates a need to see a healthcare provider:
Numbness and tingling
Failure to improve with OTC medication
Weakness, numbness, or pain in your legs
Difficulty balancing or walking
Unintended weight loss
Upper back pain affects the upper and middle part of your back in your thoracic spine. This area ranges from the base of your neck to the bottom of your rib cage.
Upper back pain has many causes, such as trauma, poor body movements, and degenerative spine diseases. Most mild cases can be handled with home care and resolved without further treatment. Upper back pain that occurs as a result of more severe problems can last for weeks to months. Upper back pain can sometimes be a sign of a serious condition like a heart attack.
A healthcare provider should check upper back pain that persists for more than two weeks. Chronic upper back pain that remains without treatment can hinder normal movements. It can limit your power to perform daily tasks and increase your risk of depression.
Frequently Asked Questions
How can you prevent upper back pain?
You can take precautions to prevent upper back pain. These strategies include using correct posture, keeping your spine aligned when sitting and standing, and using proper lifting techniques. You can also lower your risk of upper back pain by staying at a healthy weight and using back-strengthening exercises to keep your back muscles strong.
What is the prognosis for upper back pain?
The prognosis is good for most cases of back pain. Upper back and neck pain usually starts to improve within a week without any treatment. However, upper back pain caused by severe conditions can take weeks or months to improve. In some cases, surgery may be necessary to restore normal function.