What causes upper back pain?

The upper back consists of the thoracic spine (bony structures called vertebrae surrounding the nerves of the spinal cord). Between the vertebrae are spongy sacs of cartilage called discs that act as a cushion and provide a range of motion to the back. Muscles, tendons and ligaments provide additional support. Any of these structures in the back can become irritated or inflamed in response to a variety of mild to serious conditions.

A common cause of mild to severe upper back pain is a sudden movement during sports activities or home improvement projects. People who normally lead a relatively sedentary lifestyle are at increased risk for these types of strains and sprains. Alternatively, upper back pain can also be due to more serious conditions, such as fibromyalgia, spondylitis (a type of arthritis of the spine), or disc herniation. A bulging disc, for example, can put pressure on the nerve roots coming out from the spine, resulting in upper back pain. Although the lower back is a “hot spot” for bulging, or herniated, discs, the discs in the upper back can also deteriorate and rupture.

In addition, a problem in another part of the body, such as the heart, can radiate to the upper back. This is called referred upper back pain.

Structural causes of upper back pain

Upper back pain can be due to injury, inflammation, or infection of the bones and tissues including:

  • Herniated disc

  • Muscle spasm

  • Osteoarthritis

  • Osteomyelitis (infection or inflammation of the spinal bones)

  • Osteoporosis (metabolic bone disease)

  • Paget’s disease of the bone

  • Spinal degeneration (degenerative disc disease, also called spondylosis)

  • Spinal stenosis (a narrowing of the spinal canal that presses on the spinal cord or nerves)

  • Spine fracture

  • Spondylitis (infection or inflammation of the spinal joints)

  • Sprains and strains due to overuse or injury

Life-threatening causes of upper back pain

In some cases, back pain may be due to a serious or life-threatening condition that should be evaluated as soon as possible or in an emergency setting. Possible life-threatening conditions that involve upper back pain include:

  • Heart attack

  • Kidney stones and disease (although this pain is usually below the rib cage)

  • Multiple myeloma

  • Spinal tumor or cancer (the tumor can be noncancerous, also known as benign)

What are the risk factors for upper back pain?

Although anyone can experience upper back pain, there are certain risk factors that make you more likely to encounter back pain at some point in your life. Being older than 30 years of age and leading a sedentary lifestyle are the most common risk factors. These and other risk factors include:

  • Congenital (present at birth) or acquired back deformities (such as scoliosis)

  • Family history of back pain or spine disease

  • Increasing age

  • Obesity

  • Poor posture

  • Sedentary lifestyle

  • Smoking

  • Stress and anxiety

  • Weak abdominal (core) muscles

What are the potential complications of upper back pain?

The complications associated with any kind of back pain depend on the underlying disease, disorder or condition. Most cases of upper back pain are not due to serious diseases and do not lead to long-term complications. Upper back pain can usually be alleviated or minimized by physical therapy, basic self-care measures, and following the treatment plan outlined by your doctor. However, your back pain may become chronic and overwhelming. Research into the diagnosis and treatment of back pain is ongoing, so contact your health care professional for the latest information.

Over time, upper back pain can lead to complications including:

  • Absenteeism from work or school

  • Permanent nerve damage (due to a pinched nerve) including paralysis

  • Physiological and psychological response to chronic pain

  • Poor quality of life


  1. Lower back pain fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm.
  2. Warning signs of heart attack, stroke & cardiac arrest. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4595.

What is upper back pain?

Upper back pain is any type of pain or discomfort throughout the back side of the chest and upper abdominal area. The upper back area includes the shoulder blades and where the rib cage connects to the thoracic (chest region)  spine. The upper back is also referred to as the middle back or the thoracic spine.

... Read more about upper back painintroduction


What other symptoms might occur with upper back pain?

Upper back pain may occur with other symptoms depending on the underlying disease, disorder or condition. Upper back pain due to infection or inflammation may be accompanied by a fever; whereas, back pain due to fibromyalgia may include symptoms such as insomnia and fatigue. The range of symptoms that may occur with ... Read more about upper back painsymptoms

Medical Reviewer: Cynthia Haines, MD Last Annual Review Date: Aug 11, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

This Article is Filed Under: Bones, Joints and Muscles, Fibromyalgia, Back Pain

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