Upper Back Pain Symptoms, Causes & Common Questions

Understand your upper back pain symptoms, including 10 causes & common questions.

Upper Back Pain Symptom Checker

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Contents

  1. Symptoms
  2. Causes
  3. 10 Possible Upper Back Pain Conditions
  4. Treatments and Relief
  5. Real-Life Stories
  6. Questions Your Doctor May Ask
  7. Statistics
  8. Related Articles
  9. References

Upper Back Pain Symptoms

When someone says "back pain," it's common to picture someone hunched over, clutching their lower back. Complaints of upper back pain are also common. The upper back is a complex area with important structures nearby. All of our nerves are routed through the spinal column, and the largest blood vessel in the body leaves the heart and travels down the back of the chest. Additionally, the muscles in this area keep your torso upright and help move your shoulders and arms. Therefore, most pain in the upper back is due to injury to or inflammation of these structures, likely the muscles [1].

Common accompanying symptoms

If you're experiencing upper back pain, you may also experience:

  • Pain with movement of the back, neck or arms
  • Soreness
  • Weakness
  • Difficulty moving the arms

Upper Back Pain Causes

The majority of upper back pain is due to overuse of the muscles of the upper back. However, injury to your spine or other structures might cause pain [2]. The following details may help you better understand your symptoms. However, if your upper back pain worsens or persists, see a physician.

Musculoskeletal causes

Causes of upper back pain due to musculoskeletal issues may include the following.

  • Muscle strain: Exercise or overuse of the muscles of the upper back or arms may lead to pain in this region as they repair themselves.
  • Spinal injury: Fractures of the upper spine or problems with the discs in between the vertebrae may cause upper back pain symptoms.
  • Shoulder Injury: Various injuries to the shoulder may cause pain in the back of the shoulder, around the upper back.
  • Wear-and-tear: Some individuals may experience neck pain as the result of wear-and-tear of the upper portions of the spine, ranging from mild to severe.

Other causes

Other causes of upper back pain may include the following.

  • Aortic disease: Disease of the aorta, the large blood vessel that comes directly off the heart, causes sudden chest pain or back pain, especially with life-threatening tears or dissection [3,4].
  • Inflammation: Certain autoimmune diseases may attack the spine.
  • Infection: Rarely, an infection may spread to the bones of the spine, causing pain. Some infections, such as shingles, can affect the skin overlying the upper back and cause pain [5].
  • Masses: Rarely, cancers may spread to or push on the spine.

10 Possible Upper Back Pain Conditions

The list below shows results from the use of our quiz by Buoy users who experienced upper back pain. This list does not constitute medical advice and may not accurately represent what you have.

Herniated (slipped) disk in the upper back

The backbone, or spine, is made up of 26 bones called vertebrae. In between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. Although people talk about a slipped disk, nothing actually slips out of place. The outer shell of the disk ruptures, and the jelly-like substance bulges out. It may be pressing on a nerve, which is what causes the pain.A slipped disk is more likely to happen due to strain on the back, such as during heavy lifting, and older individuals are at higher risk.

Rarity: Common

Top Symptoms: upper back pain, neck pain, arm weakness, back pain that gets worse when sitting, upper spine pain

Symptoms that always occur with herniated (slipped) disk in the upper back: upper back pain

Urgency: Primary care doctor

Psoriatic arthritis

Psoriatic arthritis is a condition which causes inflammation of the joints. In most circumstances, psoriatic arthritis presents between the ages of 30 and 50 years and occurs after the manifestation of the symptoms of psoriasis, which is a disease of the skin. Psoriatic arthritis...

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Myofascial pain syndrome

Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.

The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.

This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.

Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.

Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.

Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.

Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.

Rarity: Common

Top Symptoms: dizziness, spontaneous shoulder pain, pain in the back of the neck, tender muscle knot, general numbness

Symptoms that always occur with myofascial pain syndrome: tender muscle knot

Urgency: Primary care doctor

Vertebral osteomyelitis

Vertebral osteomyelitis, or spinal osteomyelitis, is an infection in the bones of the spine. It usually affects the lumbar, or lower, back, and may be either acute or chronic.

The infection is caused by bacteria, most commonly Staphylococcus aureus and Pseudomonas aeruginosa, and by some types of fungi. These agents can travel through the bloodstream from an infected wound elsewhere in the body and reach the bones of the spine.

Most susceptible are those with weakened immune systems; poor circulation; recent injury; or undergoing hemodialysis. Osteomyelitis of the spine is the most common form of osteomyelitis in adults, though children can also be affected.

Symptoms include swelling, redness, and pain at the site of the infection, along with fever, chills, and fatigue.

A medical provider should be seen for these symptoms, as vertebral osteomyelitis can progress to abscess and cause further complications if not treated.

Diagnosis is made through blood tests, imaging of the spine, and sometimes biopsy.

Treatment involves several weeks of intravenous antibiotic or antifungal medication, which can be given as an outpatient.

Rarity: Rare

Top Symptoms: upper back pain, spontaneous neck or back pain, fever, foot numbness, upper leg numbness

Urgency: Hospital emergency room

Traumatic vertebral fracture

Vertebrae are the individual small bones that fit together, one above the other, to form the spine. If a vertebra is broken and/or dislocated due to sudden forceful injury (trauma,) this is a traumatic vertebral fracture.

The term includes fracture of the transverse processes, the "wings" of bone on either side of each vertebra. This is a less serious injury.

Automobile accidents, sports injuries, and falls from heights are common causes, as are gunshot wounds.

Symptoms include severe back pain that is worse with movement. Damage to the spinal cord causes limb numbness and weakness, with bowel and bladder dysfunction.

This is a medical emergency. One vertebra has been partially or entirely torn away from the vertebra directly below it and damaged the spinal cord. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination, neurologic tests to assess ability to move, and imaging.

Surgery stabilizes and realigns the spine, which removes pressure from the spinal cord. Rehabilitation will help the patient regain normal function.

Rarity: Common

Top Symptoms: back pain, constant back pain, severe back pain, back pain that shoots down the leg, back pain affecting the spine

Symptoms that always occur with traumatic vertebral fracture: back pain

Symptoms that never occur with traumatic vertebral fracture: mild back pain

Urgency: Emergency medical service

Upper Back Pain Symptom Checker

Take a quiz to find out what might be causing your upper back pain

Heart attack in a woman

A heart attack happens when the heart does not receive enough oxygenated blood to meet its demand, resulting in the death of heart tissue. This can be caused by a decreased supply of oxygenated blood or too high of a demand.

Symptoms include chest pain or pressure th...

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Diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis (DISH) is calcification or a bony hardening of ligaments in areas where they attach to the spine. Ligaments are supposed to be flexible, so DISH can cause symptoms such as pain, stiffness, and restricted movement.

Rarity: Rare

Top Symptoms: joint pain, upper back pain, stiff neck, stiff back, trouble swallowing

Urgency: Primary care doctor

Thoracic outlet syndrome

The "thoracic outlet" is the space on either side of the base of the neck where nerves, arteries, and veins travel beneath the collarbone. If these become compressed or damaged, the condition is called thoracic outlet syndrome or TOS.

The most common causes are trauma, such as a car accident or fall; and repetition or overuse, such as a sports injury.

Symptoms vary depending on the structures being compressed:

  • Neurogenic TOS affects the nerves. It is the most common form and creates numbness, tingling, pain, and weakness in the arms, hand, and fingers.
  • Vascular TOS affects the arteries and veins. It creates the same symptoms as neurogenic TOS as well as cold, pale hands and arms with weak pulse.

It is important to see a medical provider about these symptoms so that the damage does not become permanent.

Diagnosis is made through patient history, physical examination, imaging such as x-ray or ultrasound, and sometimes nerve conduction and blood flow studies.

Treatment involves physical therapy, pain relievers, and sometimes surgery.

Rarity: Rare

Top Symptoms: pain in one shoulder, spontaneous shoulder pain, arm weakness, arm numbness, pain in one shoulder blade

Urgency: Primary care doctor

Osteoporotic spinal fracture

Osteoporosis is a condition in which the density and quality of bone are reduced. Cracks can appear in the boney structures of the back (vertebrae) which can lead to back pain, back deformities and loss of height.

Rarity: Uncommon

Top Symptoms: mid back pain, spontaneous mid back pain, unintentional weight loss, back pain affecting the spine, back deformity

Urgency: In-person visit

Spine metastases

Metastasis is the term meaning the spread of cancer cells from tumors in other parts of the body. The spine is a common location for new tumors, or metastases, to form.

Some types of cancers, especially those of the breast, prostate, lung, thyroid, and kidney, are likely to spread to the spine. Exactly why this happens is not known.

Symptoms of spine metastases include back pain; bowel and urinary incontinence; arm or leg weakness; and hypercalcemia, or high levels of calcium in the blood.

Hypercalcemia can cause nausea and vomiting, constipation, and mental confusion.

These metastasized tumors can cause pain and fractures in the spine.

Diagnosis is made through various types of imaging, including x-ray, bone scintigraphy (bone scan,) CT scan, PET scan, and/or MRI.

Treatment is varied and is designed for each individual case. It may include IV osteoporosis medications to strengthen bones; chemotherapy to fight cancer cells; and steroids to reduce inflammation. All of these help to reduce pain, as well. Radiation therapy and surgery may also be used.

Rarity: Ultra rare

Top Symptoms: back pain, lower back pain, fatigue, mid back pain, urinary changes

Symptoms that always occur with spine metastases: back pain

Symptoms that never occur with spine metastases: back pain from overuse, lower back pain from an injury, mid back pain from an injury, mid back pain from overuse

Urgency: Primary care doctor

Upper Back Pain Treatments and Relief

Most cases of upper back pain are due to overuse of the muscles of the upper back, shoulders, and upper arms, and can be managed at home like any muscle soreness [6]. Severe or sudden-onset upper back pain cases usually require treatment by a physician.

At-home treatments

You can try the following upper back pain treatments at home.

  • Rest: Rest the muscles of the upper back and avoid intense exercises to allow the muscles to heal.
  • Ice: Ice packs can dull upper back pain symptoms.
  • Heating pad: Heating pads can also be used to dull the ache of upper back pain.
  • Pain medication: Over-the-counter pain medications can relieve dull pain in the upper back, such as NSAIDs like ibuprofen (Advil, Motrin). Acetaminophen (Tylenol) may also help.
  • Stretches: Stretches can help loosen tight upper back muscles.
  • Massage: Massage of the upper back can help loosen tight muscles.
  • Posture: If you spend most of your day in a position that strains your upper back or neck muscles, working on posture can help reduce upper back pain long-term.

When to see a doctor

If your upper back pain is not resolving, you should see a physician. He or she may recommend the following treatments for your upper back pain.

  • Physical therapy: Physical therapy regimens can help strengthen upper back muscles and other supporting muscles to assist in healing strained muscles.
  • Medication: Certain conditions that cause upper back pain symptoms can be treated with medications. For instance, medications that reduce muscle spasms can help with muscle soreness, and certain spinal fractures require vitamin supplementation.
  • Surgery: In rare cases, upper back pain may require surgery. This is true for certain spinal fractures and diseases of the aorta.

When upper back pain is an emergency

You should seek help without delay if you have:

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Questions Your Doctor May Ask About Upper Back Pain

To diagnose this condition, your doctor would likely ask the following questions:

  • Turn your head toward the side of your body that is hurting. Lift your head up as someone else pushes down on your head. Does this cause greater pain in your upper body? (This is known as Spurling's test.)
  • What is your body mass?
  • Do you feel a painful, tight knot or band in your muscle anywhere on the body?
  • Is the pain in your upper back moving down your arm?

If you've answered yes to one or more of these questions

Please take a quiz to find out what might be causing your upper back pain. These questions are also covered.

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Upper Back Pain Symptom Checker Statistics

People who have experienced upper back pain have also experienced:

  • 7% Rib Pain
  • 5% Rib Pain On One Side
  • 4% Chest Pain

People who have experienced upper back pain were most often matched with:

  • 33% Herniated (Slipped) Disk In The Upper Back
  • 33% Psoriatic Arthritis
  • 33% Myofascial Pain Syndrome

People who have experienced upper back pain had symptoms persist for:

  • 34% Less than a day
  • 27% Less than a week
  • 21% Over a month

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

Upper Back Pain Symptom Checker

Take a quiz to find out what might be causing your upper back pain

References

  1. Blahd Jr WH, Thompson EG, Husney A, Romito K, eds. Upper and Middle Back Pain. University of Michigan: Michigan Medicine. Updated September 20, 2018. UofM Health Link.
  2. Back Pain. UW Medicine. UW Medicine Link.
  3. Thoracic Aortic Aneurysm and Aortic Dissection. Johns Hopkins Medicine. Johns Hopkins Medicine Link.
  4. Thoracic Aortic Aneurysm and Aortic Dissection. Johns Hopkins Medicine. Johns Hopkins Medicine Link.
  5. Patient Education: Shingles (Beyond the Basics). UpToDate. UpToDate Link.
  6. Blahd Jr WH, Thompson EG, Husney A, Romito K, eds. Upper and Middle Back Pain. UW Health. Updated February 23, 2018. UW Health Link.

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