Why Do I have Upper Back Pain?

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Did you know that estimates are that 15 -19% of people have chronic upper back pain? Upper back pain can adversely affect everyday activities and lead to additional problems with misalignment that may also affect the lower back.

Upper back pain involves pain in any of the muscles in the neck and thoracic spine. The pain may vary in severity. It can include sharp pain, aching, or a burning sensation. Some people may also develop stiffness and a decrease in range of motion.

Various factors may cause upper back pain, including injuries, orthopedic conditions, and poor posture. In some cases, multiple issues contribute to upper back pain. For example, poor posture and osteoarthritis may cause aching or sharp pain in the upper back.

Learning more about upper back pain can help you take the needed steps to manage it effectively. The guide below covers causes, symptoms, diagnosis, treatments, and prevention of upper back pain.

Understanding Upper Back Pain

Your back is made up of various muscles that help you sit, stand, turn, and lean. Your upper back also plays a big role in keeping your trunk stable. Because of these important functions, if you have upper back pain, it can affect your posture and normal movements and activities.

Anatomy of the upper back

Your upper back consists of various bones, muscles and nerves, including both superficial and deep back muscles, including:

• Trapezius: This muscle is located along the spine and the beginning of the neck.
• Latissimus dorsi: The latissimus dorsi extends from the shoulder blades to the lower back. It is the largest muscle of the upper back. It helps stabilize the back, swing the arms when walking, and is an accessory muscle for breathing.
• Levator scapulae: This muscle is located in the lower neck area. It helps stabilize the neck.
• Rhomboids: The rhomboids are located between the shoulder blades and help control scapula movement. They also play a role in posture.
• Vertebrae: The vertebrae are the bones in the spine. In the upper back they include the cervical and thoracic vertebrae.
• Intervertebral discs: The discs are located between each vertebra and provide cushion for the bones in the spine.
• Facet joints: The facet joints are the connections between the vertebra and allow your back to bend and twist.

Causes of Upper Back Pain

It is common to ask, “why do I have upper back pain?” The answer is it can vary. There are several possible causes of upper back pain, including those listed below.

• Muscle strain: Any of the muscles of the upper back can become strained from overuse
• Poor posture: Poor posture, such as sitting with your head jutting forward, can lead to spinal misalignment and upper back pain.
• Arthritis: Osteoarthritis is a common form of arthritis. It involves breakdown of the cartilage in the joints and can lead to facet joint pain in the upper back.
• Injury: An injury to any of the muscles, ligaments, or bones in the upper back can lead to pain.
• Herniated discs: A herniated disc develops when the inner part of the disc pushes through the outer ring of the disc. It can put pressure on the nerves causing pain.
• Gallbladder issue: Gallbladder problems can include gallstones which causes inflammation. Because of the location of the gallbladder, the inflammation can lead to referred pain that may be felt in the upper back usually on the right side.
• Spine deformities: Spinal deformities can include conditions, such as kyphosis, which is an upper back forward curvature.
• Fibromyalgia: Fibromyalgia is a chronic condition that causes tenderness and pain in various areas of the body, including the upper back.
• Spinal stenosis: This condition involves narrowing of the spinal column putting pressure on the nerves.
• Cancer: Cancer can originate or spread to areas of the body that cause pain in the upper back.

Location of Upper Back Pain

Different conditions, injuries, and diseases can affect various areas of the upper back. However, determining the area where your upper back pain is may provide clues to the cause. It is helpful to identify upper back pain causes to find the best treatment.

Below are potential causes of upper back pain by location.

• Cervical area pain: This may include the cervical vertebrae, discs, and trapezius muscles. Various issues may cause pain in this area, including muscle strain and osteoarthritis.
• Shoulder blade area pain: This may include the rhomboids and latissimus dorsi. The bones of the spine and facet joints may also cause pain due to arthritis and injury. Poor posture leading to muscle tightness may also cause upper back pain.
• Upper thoracic pain: Upper thoracic area pain may occur to due strain of the latissimus dorsi muscle and also by injuries arthritis to the thoracic vertebrae, discs or facet joints.

Upper Back Pain Risk Factors

Anyone can develop upper back pain. However, certain factors increase your risk, such as:

• Age: As you age, you are more likely to develop conditions such as spinal stenosis and arthritis that cause upper back pain.
• Being out of shape: Having weak muscles and being out of shape may increase the likelihood of developing injuries and pain.
• Weight: Individuals who are overweight increase the stress on their vertebrae, which may cause back pain.
• Medical conditions: Certain types of medical conditions, such as rheumatoid arthritis and osteoarthritis, increase the risk of upper back pain.
• Smoking: Smoking affects how well you heal. It can affect how fast you recover from a back injury.

Symptoms of Upper Back Pain

Symptoms of upper back may vary in duration, location, and intensity. They may range from mild to severe. The pain may include sharp pain in the upper back, burning, or aching.

Associated symptoms may include:

• Stiffness
• Tingling
• Numbness
• Radiating pain down the front or back of the leg

Diagnosing Upper Back Pain

Because upper back pain can have variable causes, in some cases, it is important to have a medical evaluation. Consider seeing a doctor in the following instances:

• Upper back pain is severe
• Pain worsens even with home treatment
• Pain lasting for more than a week
• Pain accompanied by weakness, numbness, or tingling in the arms or legs

To diagnose the cause of upper back pain, your doctor will do a physical exam, take a medical history, and order some type of imaging test. Imaging tests create a picture of your back muscles, bones, joints, and ligaments. Possible imaging tests may include:

• X-ray
• CT scan
• MRI

Treatment Options for Upper Back Pain

There are several treatment options for upper back pain. Treatment may vary based on the underlying cause and severity of symptoms. In most cases, non-surgical treatments are the first option recommended.

Non-surgical treatment for upper back pain includes:

• Over the counter pain relievers
• Rest
• Heat or cold therapy
• Stretching
• Physical therapy
• Chiropractic care
• Massage

If less invasive treatment does not help reduce pain, surgery may be an option. Surgical interventions may include:

• Cervical fusion
• Cervical artificial disc replacement
• Cervical discectomy

Prevention of Upper Back Pain

Taking steps to prevent upper back pain from returning is vital. There are several things you can do to prevention back pain, such as:

Ergonomic Tips

• Try to use good posture when sitting, keeping your elbows and knees at a 90 degree angle. 
• Do not round the shoulders or hunch forward. 
• Maintain an even distribution of weight when seated. 
• Take frequent breaks when sitting for prolonged periods.
• Chiropractic care

Exercising and Stretching

Regularly doing both strengthening and stretching exercises for the upper back is a great way to prevent upper back pain. Consider doing exercises, such as:

• Plank
• Bridge
• Cat-cow
• Child’s pose

Maintain good posture

Until it becomes a habit, be intentional about maintaining good posture. Remind yourself to keep your back straight. It is also helpful to keep your ears, shoulders, and hips in line as much as possible when walking and sitting. Keep your shoulders relaxed and dropped away from your ears.

Frequently Asked Questions

If you have upper back pain, you may have questions, such as those listed below.

Can dehydration cause upper back pain?

Dehydration can cause upper back pain. The fluid in your discs gradually decreases throughout the day. If you become dehydrated, you may not have enough fluid to keep your spine well lubricated. Without that lubrication, you may be more likely to develop upper back pain.

Can upper back pain cause headaches?

Headaches can occur as a result of upper back pain. Your upper back and neck muscles can become tight. This tension and stiffness can lead to referred pain and cause headaches.

Why is my upper back sore after running?

It is possible for the upper back to become sore after running. This may happen for a few reasons. For example, your running position may change as you become fatigued. This may cause poor posture, such as slouching your upper back or tensing your shoulder muscles. The result may be poor posture placing added stress in your neck and upper back leading to pain.

Conclusion

Upper back pain can occur for a variety of reasons, such as poor posture, injury, and arthritis. In addition to pain, you may also develop numbness, tingling and referred pain to other areas of the lower back.

Preventing upper back pain through strengthening, stretching, and good posture is always your best bet.

Treatment options can include medication, physical therapy, and chiropractic care. In some cases, noninvasive treatment is not effective, surgery may be recommended. In many cases, upper back pain is treatable with home remedies. But there are times when you should seek professional medical attention. See a doctor in the following cases:

• Pain becomes worse
• Upper back pain lasts longer than a week
• Pain is severe

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