What Is the Upper Back?

Upper back pain is any type of pain or discomfort throughout the area of the thoracic spine. The thoracic spine and upper back run from the cervical spine in the neck to the lumbar spine in the lower back. The upper back area includes the shoulder blades and back of the rib cage.

Most people will experience back pain at some point in their lives. However, pain in the upper back is not as common as lower back pain because the thoracic spine does not move as much as the spine in the lower back and neck.

Upper back pain may either be acute, lasting briefly, or it may be chronic, lasting longer than three months. Your pain may be dull and throbbing or sharp and stabbing. You may be in constant pain, or the pain may occur only during a particular activity, such as lifting grocery bags or after working at your desk for a prolonged period of time.

In addition to the thoracic spine and shoulder blades, there are numerous nerves, muscles, tendons, and ligaments in the upper back. Any of these structures can become irritated or inflamed in response to a variety of different factors and conditions. This includes poor posture, overuse, trauma, arthritis and, rarely, bone cancer. However, most upper back pain causes involve muscle irritation or joint problems and are usually not a cause for concern.

Common causes of upper back pain

1. Muscle deconditioning and poor posture

People can condition their muscles over time to be stronger or more enduring through exercises and weight training. The reverse is also true. Humans may decondition their muscles over time by not using them correctly. In some muscles, including back muscles, deconditioning is as easy as sitting at a desk with incorrect posture for too long. A person may do this while at work.

2. Muscle overuse

Overusing back muscles is another common cause of upper back pain. This typically occurs due to repeating the same motions over time. This can be a cause of:

• muscle strain
• tightness
• irritation

The classic example of how this occurs is a pitcher in baseball, who does a similar motion every time they pitch, which can often take a toll on their shoulder.

Other repetitive activities may cause similar pain. Someone who has to make the same motion all day, or lifts things above their head throughout the day, for example, may start to experience muscle irritation, tightness, or strain. This could turn into chronic pain if they ignore these signs.

3. Traumatic injury

A traumatic injury can also lead to back pain. This may be the result of situations that include:

• car accidents
• slipping and falling
• work-related accidents
• lifting incorrectly
• working out too hard

The injury is sometimes obvious, and pain appears just after the incident. At other times, the pain may not develop until later or the next day. Traumatic injuries can be severe, and issues from injuries, for example, fractured vertebrae, put a person at risk of lasting complications, including chronic pain, nerve damage, and paralysis.

A doctor should look at all potential back injuries as it is vital that they heal properly to avoid long-term pain. A doctor may refer the person to a physiologist or physical therapist to help muscle injuries heal properly. Severe injuries may require surgery.

4. Herniated disc

Herniated discs are more common in the lower back but may sometimes happen in the upper back too. Discs are the soft, rubbery cushions between each vertebra. Herniated discs occur when a piece of this cushion pokes through and puts pressure on the spine.

Even a small amount of pressure can result in significant pain in the middle of the back, as well as other symptoms, including numbness or weakness in the arms or legs. Most people do not need surgery for herniated discs and will recover with rest or by taking anti-inflammatory medications.

4. Spinal infection

Rarely, an infection may be the cause of upper back pain. A spinal epidural abscess is a collection of germs and pus that form between the spinal cord and bones of the spine. The abscess can grow and swell, leading to pain. Early diagnosis is critical, and doctors will treat a spinal abscess quickly to avoid serious complications.

Antibiotics may help, and surgery may be necessary to clear the abscess and reduce the risk of complications. A study posted to BioMed Research International notes that mortality can vary from 2 to 25 percentTrusted Source in people with spinal epidural abscess, typically, because it may take too long to diagnose their condition.

Risk factors

While upper back pain is often the result of acute trauma or repetitive motion injury, some factors will make you more susceptible:

• Smoking
• Being overweight
• Excessive lifting or carrying
• Participating in contact sports
• Spending long hours at a computer (poor posture)
• Low muscle tone

It may not be possible to prevent all causes of upper back pain, but there are some easy steps people can take that may avoid some of the more common causes. These include:

• Take regular breaks from sitting or lying down to stretch and move different muscle groups.
• Take frequent breaks when working at a desk to stretch, so the muscles stay loose and strong.
• Take a few minutes to stretch the muscles or warm up the body before any activities.
• People who lift heavy objects should avoid twisting or lifting with their back.
• Have regular massages to help work out the tension of the muscles.
• Work with a physical therapist to strengthen weak muscles and keep pressure off the joints.
• Avoid wearing heavy backpacks or purses.
• Be conscious of posture at all times, walking upright and sitting correctly, using back supports if necessary.