Read below about upper back pain, including causes, treatment options and remedies. Or get a personalized analysis of your upper back pain from our A.I. health assistant. At Buoy, we build tools that help you know what’s wrong right now and how to get the right care.

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Upper Back Pain Symptoms

When someone says "back pain," most people think of the more common lower back pain. However, upper back pain is also a cause of significant distress for people. The upper back is a complex area and is nearby important structures. All of the nerves that allow us to feel or move are routed through the spinal column featured prominently in the middle, and the largest blood vessel in the body leaves the heart and travels down the back of the chest, again near the upper back. Additionally, the muscles in this region are important for keeping your torso upright and for moving your shoulders and arms every which way. Thus, most pain in the upper back is due to injury to or inflammation of these structures, most typically the muscles [1].

Upper back pain may be associated with these common symptoms:

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

Upper Back Pain Causes Overview

The majority of upper back pain is due to overuse of the muscles of the upper back, as one might suspect. But your upper back is also home to your spine, and a number of other structures that might be injured and cause pain in that area [2].

Musculoskeletal upper back pain causes:

  • 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 upper back pain causes:

  • Aortic Disease: Disease of the aorta, the large blood vessel that comes directly off the heart, especially life-threatening tears or dissection, causes sudden chest pain or back pain [3,4].
  • Inflammation: Certain autoimmune diseases may attack the spine, causing upper back pain.
  • Infection: Rarely, 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, causing upper back pain.

A.I. Health Assistant Causes for Upper Back Pain

The list below shows results from the use of our A.I. Health Assistant by Buoy users who experienced upper back pain. This list does not constitute medical advice.

  1. 1.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.

    The pain associated with a slipped disk usually goes away within six weeks. If the pain lasts longer, consult a doctor. They may send you to see a back specialist for an MRI of your spine, and surgery may be considered.

    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
  2. 2.Psoriatic Arthritis

    Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. Some people who have psoriasis also get a form of arthritis (inflammation and swelling of joints) called psoriatic arthritis.

    This type of arthritis can be managed with treatment, and permanent damage can be prevented. However, the underlying cause (psoriasis) is currently incurable.

    Rarity:
    Rare
    Top Symptoms:
    shoulder pain, lower back pain, joint pain, upper back pain, hip pain
    Urgency:
    Primary care doctor
  3. 3.Myofascial Pain Syndrome

    Myofascial pain syndrome is a chronic musculoskeletal syndrome caused by trigger points within muscle. Pressure on these points causes pain in the area around the point as well as in other body parts, a phenomenon known as referred pain.

    Resolution of pain is dependent on type of treatment.

    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
  4. 4.Vertebral Osteomyelitis

    Infection of the spinal bones (Vertebral Osteomyelitis) is caused by the spread of bacteria through the blood from another body part that lands in the spine. It's typically caused by bugs named Staph. Aureus (40-50% of the time), streptococci (12%), e.coli (9%), and Pseudomonas aeruginosa (6%).

    6 weeks of antibiotics typically clears things up

    Rarity:
    Rare
    Top Symptoms:
    upper back pain, spontaneous neck or back pain, fever, foot numbness, upper leg numbness
    Urgency:
    Hospital emergency room
  5. 5.Traumatic Vertebral Fracture

    Vertebral fracture is a fracture or dislocation of a vertebra that can cause bone fragments to pinch and damage the spinal nerves or spinal cord. Most spinal fractures occur from car accidents, falls, gunshot, or sports.

    Variable depending on severity (months)

    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 Checker

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  6. 6.Heart Attack in a Woman

    Most heart attacks happen when a clot in the coronary artery blocks the supply of blood and oxygen to the heart. Often this leads to an irregular heartbeat - called an arrhythmia - that causes a severe decrease in the pumping function of the heart.

    Indefinite

    Rarity:
    Uncommon
    Top Symptoms:
    abdominal pain (stomach ache), nausea, pain in one arm, chest pain, shortness of breath
    Urgency:
    Emergency medical service
  7. 7.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.

    DISH is a lifelong disease.

    Rarity:
    Rare
    Top Symptoms:
    joint pain, upper back pain, stiff neck, stiff back, trouble swallowing
    Urgency:
    Primary care doctor
  8. 8.Thoracic Outlet Syndrome

    Thoracic Outlet Syndrome is the compression of the nerves and/or blood vessels that run through the upper chest. It can occur as a result of trauma, surgery, growths in the body, or just randomly.

    Resolves with treatment (30% relapse)

    Rarity:
    Rare
    Top Symptoms:
    pain in one shoulder, spontaneous shoulder pain, arm weakness, arm numbness, pain in one shoulder blade
    Urgency:
    Primary care doctor
  9. 9.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.

    Weeks to months

    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
  10. 10.Spine Metastases

    Bone metastases occur when tumor cells migrate from the original tumor site and cause a secondary tumor elsewhere in the body. The spine is a common location for metastases to appear and symptoms generally include pain and tingling.

    Outcome is dependent on severity of disease and treatment given.

    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 thus be managed at home and treated like you would treat any muscle soreness [6]. Severe or sudden-onset upper back pain cases usually require treatment by a physician.

At-home upper back pain treatments:

  • Rest: Resting the muscles of the upper back and avoiding exercises that strain them can reduce upper back pain and 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.
  • Tylenol (acetaminophen) or NSAIDs: Over-the-counter pain medications can dull pain in the upper back.
  • 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.

Professional upper back pain treatments:

  • 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 spasm 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.

You should seek help without delay if you have:

Questions Your Doctor May Ask About Upper Back Pain

  • Q.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.)
  • Q.What is your body mass?
  • Q.Do you feel a painful, tight knot or band in your muscle anywhere on the body?
  • Q.Is the pain in your upper back moving down your arm?

If you've answered yes to one or more of these questions, try our upper back pain symptom checker to find out more.

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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 had symptoms persist for:

    • 34% Less Than a Day
    • 27% Less Than a Week
    • 21% Over a Month
  • 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
  • Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

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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.