Upper Back Pain: Causes & How to Get Relief

Key takeaways:

• Upper back pain can stem from various causes, ranging from minor muscle strain to serious health issues requiring medical attention.
• Recognizing the specific symptoms and understanding when to seek care is crucial for effective management.
• Simple at-home remedies can often provide relief, but persistent or worsening pain may need professional evaluation.

Upper back pain is a condition many people face, yet it often goes overlooked compared to issues like lower back pain. Discomfort in this region, which spans the area between your shoulders and the base of your neck, can make even basic activities difficult. From sitting at a desk all day to lifting something heavy, the reasons behind upper back pain vary widely, but understanding these causes is the first step toward relief.

Upper back pain defined

Upper back pain refers to discomfort or pain felt in the thoracic spine, which spans from the base of your neck to the bottom of your ribcage. Unlike the lower back, this part of your spine is less flexible, providing stability and support for your upper body. Pain in this area can result from strained muscles, joint problems, or even issues with nearby organs.

Health risks associated with upper back pain

While upper back pain is often harmless and resolves with time or minor interventions, it can occasionally signal a more serious problem. Spinal conditions like herniated discs or osteoarthritis can lead to chronic discomfort. Additionally, referred pain from the lungs, heart, or other organs might manifest as upper back pain.

For example, pleurisy (inflammation of the lining around your lungs) can cause sharp back pain when breathing deeply. Gallbladder problems, such as gallstones, might present as pain in the upper back, especially after eating fatty meals. Recognizing these risks and monitoring other symptoms can help you decide when to seek medical attention.

Symptoms associated with upper back pain

Upper back pain symptoms vary depending on the underlying cause, ranging from mild tightness to severe, debilitating discomfort.

Tightness or stiffness

Tightness or stiffness in the upper back often arises from muscle strain or prolonged poor posture (like slouching at a desk). You may find it difficult to turn your head or lift your arms without discomfort. While this type of pain typically resolves with rest or gentle stretches, chronic stiffness might indicate deeper issues like muscle imbalances.

Radiating pain

Pain that radiates from the upper back to your shoulders or arms often points to nerve involvement, such as a pinched nerve from a herniated disc. This type of pain can feel sharp, shooting, or even like a persistent ache. Accompanying symptoms, like tingling or numbness, suggest nerve irritation and should be evaluated promptly.

Pain that worsens with breathing

Pain that becomes more intense with deep breaths could signal lung-related conditions like pneumonia or pleurisy. In these cases, the pain might be sharp and localized but can spread to the shoulder or back. Additional symptoms, like shortness of breath or fever, are red flags for seeking medical care.

Burning or sharp pain

A burning or sharp sensation in the upper back can indicate nerve irritation, shingles (a viral infection causing a painful rash), or muscle tears. This type of pain is often localized and may worsen with movement or touch. If the pain persists or is paired with unusual symptoms, consulting a healthcare provider is essential.

Causes of upper back pain

Upper back pain can have a variety of causes, ranging from simple muscle strain to more complex medical conditions. Identifying the root cause can guide effective treatment.

Muscle strain

Muscle strain is a common cause of upper back pain, often due to overuse, sudden movements, or heavy lifting. Activities like repetitive pulling or twisting motions can overstretch or tear muscles, leading to soreness or swelling. Rest, ice, and gentle stretching are typically effective for recovery.

Poor posture

Poor posture, such as slumping over a phone or desk, places undue stress on the muscles supporting your spine. Over time, this strain can lead to pain, stiffness, or even chronic discomfort. Correcting posture with ergonomic tools or exercises can help alleviate and prevent these issues.

Nerve compression

Nerve compression, often caused by herniated discs or bone spurs, can lead to radiating pain, numbness, or weakness in the upper back and arms. This condition, called a pinched nerve, may require treatments like physical therapy, medications, or surgery in severe cases.

Referred pain from internal organs

Pain in the upper back isn’t always musculoskeletal. Gallbladder issues, like gallstones, can cause referred pain in this area, often accompanied by nausea or abdominal discomfort. Similarly, lung conditions, like pneumonia, can produce sharp upper back pain, especially with breathing.

Other causes of upper back pain based on another symptom or situation

Upper back pain often varies in presentation depending on its underlying cause. Identifying these patterns, especially when combined with other symptoms (like radiating pain or difficulty breathing), can help determine possible triggers and inform the need for treatment.

Intense or severe upper back pain

Severe upper back pain may result from acute injuries, like a muscle tear, or more serious conditions, such as spinal fractures or gallbladder inflammation. If the pain is accompanied by difficulty breathing, chest discomfort, or neurological symptoms, it requires immediate medical evaluation.

Sharp or stabbing upper back pain

Sharp pain is often linked to nerve issues, such as a herniated disc, or injuries like muscle tears. Sudden sharp pain following physical activity should be assessed for potential fractures or ligament damage.

Burning upper back pain

Burning pain is commonly associated with nerve irritation, as seen in shingles or sciatica. It may also result from overworked muscles. If burning pain is paired with unusual symptoms, like a rash, seek medical care to evaluate potential underlying conditions.

Upper back pain when breathing or inhaling

Pain that worsens with breathing often points to lung-related issues like pleurisy, pneumonia, or pulmonary embolism. These conditions can cause sharp discomfort in the upper back, particularly with deep breaths, and should be treated promptly.

Upper back pain when coughing

Coughing can cause upper back pain, especially if it’s forceful or frequent, straining the muscles in the chest and back. In some cases, pain when coughing may indicate conditions like pneumonia, bronchitis, or even a herniated disc, which worsens under pressure. Persistent pain associated with coughing, especially if paired with fever or shortness of breath, should be evaluated by a doctor.

Upper right back pain

Pain in the upper right back often stems from muscle strain, poor posture, or referred pain from internal organs like the gallbladder or liver. Gallstones, for example, may cause pain after eating, especially meals high in fat. If upper right back pain is severe or persists, monitoring for additional symptoms like nausea or abdominal discomfort is essential.

Upper back pain between shoulder blades

Pain in this region may result from muscle tension, poor posture, or overuse (such as repetitive lifting). It’s sometimes described as a dull ache but may worsen with movement. Other causes include spinal issues, such as herniated discs, or organ-related problems like acid reflux, which can refer pain to this area.

Upper left back pain

While similar to right-sided pain, upper left back pain can indicate muscle strain or conditions like pinched nerves. It may also suggest issues with the heart, spleen, or stomach (such as ulcers), especially if paired with additional symptoms like chest discomfort or nausea.

Upper back and neck pain

When upper back pain extends into the neck, it often points to poor posture or strain from activities like prolonged screen use. This can result in tension headaches or stiffness that limits movement. Neck-related pain might also signal cervical spine issues, requiring a more thorough evaluation.

Upper back pain during pregnancy

Hormonal changes during pregnancy loosen ligaments, increasing strain on the back and shoulders. As the baby grows, shifts in weight distribution can cause upper back pain, especially in the later stages. Gentle stretching, supportive pillows, and physical therapy may provide relief, but severe or persistent pain should be assessed to rule out complications like preeclampsia.

How to get short-term relief from upper back pain

Managing upper back pain often starts with simple at-home remedies. Before trying new methods, consult your healthcare provider, especially if the pain is severe or doesn’t improve.

Heat and cold therapies

Applying heat can relax tight muscles, while cold reduces inflammation and numbs pain. Alternate between heat and cold for 15–20 minutes, using a cloth barrier to protect your skin and taking breaks of at least 20 minutes in between sessions. If the pain persists or worsens, seek medical advice.

Gentle stretching

Stretching helps improve flexibility and relieve tension in the back. Focus on slow, controlled movements (like a seated forward fold or shoulder rolls) to avoid strain. Discuss specific stretches with your healthcare provider to ensure they suit your needs.

Massage or foam rolling

Massaging the affected area or using a foam roller can improve circulation and reduce stiffness. Be cautious with technique, as improper use can worsen symptoms. For persistent pain, consult a professional or ask your provider if massage is appropriate.

How to prevent upper back pain

Preventing upper back pain involves small lifestyle changes and maintaining a balanced, active routine. Always check with your healthcare provider before making significant adjustments.

Practice good posture

Proper posture reduces stress on the muscles and joints. Sit and stand with your shoulders relaxed, back straight, and ears aligned over your shoulders. Use ergonomic tools, such as lumbar cushions or standing desks, for added support.

Stay active

Regular physical activity strengthens the back and core muscles, helping to stabilize the spine. Low-impact exercises like swimming or yoga can improve flexibility and reduce the risk of strain. Speak to your provider before starting any new fitness program.

Avoid repetitive strain

Repetitive movements, like lifting heavy objects, can strain the back. Use proper lifting techniques (bend at your knees, not your waist) and take breaks to stretch during prolonged activities.

When you should see a doctor about upper back pain

Knowing when to seek medical care for upper back pain is crucial for addressing potential complications early.

You should see a doctor if:

• Pain lasts more than two weeks or worsens over time.
• You experience numbness, tingling, or mild weakness in your arms or shoulders.
• Pain disrupts your daily activities, sleep, or overall quality of life.

You should go to the emergency room if:

• Pain is sudden, severe, and worsening rapidly.
• You lose control of your bowel or bladder or experience significant weakness in your arms or shoulders.
• Pain is accompanied by shortness of breath, chest discomfort, or dizziness.
• You notice symptoms like nausea, fever, or severe abdominal tenderness.

Questions to ask your doctor about upper back pain

If you’re experiencing upper back pain, asking your doctor the right questions can ensure the best care.

• What is causing my upper back pain, and how can we confirm it?
• What treatment options are available, and what are their potential risks or benefits?
• Are there any lifestyle changes I can make to prevent or reduce my pain?
• What symptoms should I monitor that would require immediate medical attention?

How a doctor may help treat upper back pain

Medical treatments for upper back pain target both immediate relief and long-term prevention.

Medications

Doctors may recommend anti-inflammatory medications, muscle relaxants, or corticosteroids to reduce pain and swelling.

Physical therapy

A physical therapist can develop a customized plan to improve posture, strengthen muscles, and prevent future pain.

Trigger point injections

For persistent pain, trigger point injections deliver anesthetics or corticosteroids directly into a tender muscle area to relieve tension and reduce inflammation (e.g., treating knots in the upper back that don't improve with stretching).

Frequently asked questions: upper back pain

Upper back pain often raises many questions, especially when identifying potential causes or understanding the seriousness of symptoms. Here are answers to some common concerns.

Is upper back pain a sign of cancer?

While rare, persistent or worsening upper back pain, especially with unexplained weight loss or other symptoms, could signal serious conditions like cancer. It’s important to consult a doctor for persistent or unusual pain.

How long should upper back pain last before you see a doctor?

If pain lasts more than two weeks or worsens despite at-home care, seek medical evaluation to rule out serious conditions.

What organs can cause upper back pain?

Organs such as the lungs, gallbladder, and heart can sometimes cause referred pain to the upper back (pain felt in a different location than the actual source). Gallbladder issues, like inflammation or gallstones, may lead to upper right back discomfort, while lung problems, such as pneumonia or pleurisy, can result in sharp pain that worsens with deep breaths.

Final thoughts

Recognizing the symptoms and causes of upper back pain and knowing when to seek care empowers you to manage discomfort effectively. Prompt attention—whether through home remedies or medical treatment—can restore mobility and improve your quality of life.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Pallabi Sanyal-Dey, MD.

Sources

Casiano VE, Sarwan G, Dydyk AM, et al. Back Pain. [Updated 2023 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK538173/

Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/

Du SH, Zhang YH, Yang QH, Wang YC, Fang Y, Wang XQ. Spinal posture assessment and low back pain. EFORT Open Rev. 2023 Sep 1;8(9):708-718. doi: 10.1530/EOR-23-0025. PMID: 37655847; PMCID: PMC10548303. https://pmc.ncbi.nlm.nih.gov/articles/PMC10548303/pdf/EOR-23-0025.pdf

Mackinnon SE. Pathophysiology of nerve compression. Hand Clin. 2002 May;18(2):231-41. doi: 10.1016/s0749-0712(01)00012-9. PMID: 12371026. https://www.sciencedirect.com/science/article/abs/pii/S0749071201000129?via%3Dihub

Appasamy M, Lam C, Alm J, Chadwick AL. Trigger Point Injections. Phys Med Rehabil Clin N Am. 2022 May;33(2):307-333. doi: 10.1016/j.pmr.2022.01.011. PMID: 35526973; PMCID: PMC9116734. https://pmc.ncbi.nlm.nih.gov/articles/PMC9116734/pdf/nihms-1774118.pdf

Smrcina Z, Woelfel S, Burcal C. A Systematic Review of the Effectiveness of Core Stability Exercises in Patients with Non-Specific Low Back Pain. Int J Sports Phys Ther. 2022 Aug 1;17(5):766-774. doi: 10.26603/001c.37251. PMID: 35949382; PMCID: PMC9340836. https://pmc.ncbi.nlm.nih.gov/articles/PMC9340836/

Bobé-Armant F, Buil-Arasanz ME, Trubat-Muñoz G, Llor-Vilà C, Vicente-Guillen V. Cholelithiasis presented as chronic right back pain. J Family Med Prim Care. 2014 Oct-Dec;3(4):458-60. doi: 10.4103/2249-4863.148150. PMID: 25657967; PMCID: PMC4311366. https://pmc.ncbi.nlm.nih.gov/articles/PMC4311366/pdf/JFMPC-3-458.pdf

Reamy BV, Williams PM, Odom MR. Pleuritic Chest Pain: Sorting Through the Differential Diagnosis. Am Fam Physician. 2017 Sep 1;96(5):306-312. PMID: 28925655. https://www.aafp.org/pubs/afp/issues/2017/0901/p306.html

Mou AD, Barman Z, Hasan M, Miah R, Hafsa JM, Das Trisha A, Ali N. Prevalence of preeclampsia and the associated risk factors among pregnant women in Bangladesh. Sci Rep. 2021 Oct 29;11(1):21339. doi: 10.1038/s41598-021-00839-w. PMID: 34716385; PMCID: PMC8556297. https://pmc.ncbi.nlm.nih.gov/articles/PMC8556297/pdf/41598_2021_Article_839.pdf

Mitchell B, Imonugo O, Tripp JE. Anatomy, Back, Extrinsic Muscles. [Updated 2024 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK537216/ 

Fiat F, Merghes PE, Scurtu AD, Almajan Guta B, Dehelean CA, Varan N, Bernad E. The Main Changes in Pregnancy-Therapeutic Approach to Musculoskeletal Pain. Medicina (Kaunas). 2022 Aug 17;58(8):1115. doi: 10.3390/medicina58081115. PMID: 36013582; PMCID: PMC9414568. https://pmc.ncbi.nlm.nih.gov/articles/PMC9414568/pdf/medicina-58-01115.pdf