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Who To See For Upper Back Pain

When To Go To The Doctor

Lower Back Pain

You cant always assume the discomfort is no big deal. If pain lingers for more than a few days or requires regular pain medications, you should be evaluated by your physician, says Leda Ghannad, MD, assistant professor of orthopedic surgery and physical medicine and rehabilitation at Rush University Medical Center. Another sign: if the pain limits your abilities in your day-to-day life, like you have to call off work to stay in bed. Following are signs you need to get medical help, pronto.

Anatomical Structure And Upper Back Pain

The upper back is much more stable than the neck and low back . It doesn’t move as much as they do because one of its main jobs is to protect the internal organs in the chest. It does this in conjunction with the ribs, which are attached to the thoracic vertebrae.

Because the thoracic spine doesn’t move as much, it’s less prone to the joint and disc problems that more commonly affect the neck and low back. That doesn’t mean that you can’t have a herniated disc causing your upper back pain, but it is much less common.

It’s also less common to have degenerative problems in the thoracic spine. The neck and low back move more, so the joints and discs may wear out sooner from use, overuse, and misuse.

More on this topic

Potential Causes Of Upper And Middle Back Pain

In order to get the best, most effective treatment for your upper back pain , you should understand what may be causing it. Your doctor can help you figure that out, but here are some common causes.

Upper back pain involves your upper and middle back . The causes widely vary and may include poor posture or injury from minor trauma . Photo Source:

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Be Proactive About Your Back Pain Treatment Plan

If the current treatment plan for your back pain isn’t working, consider researching various spine specialists on your own. There may be a different type of health professional who is better suited to treat your condition.

Before you see a specialist, write down a clear description of your symptoms and the treatments you’ve tried. This written record can help you to better communicate with your new doctor. Also, don’t be shy about seeking a second opinion if you think it will help alleviate your back pain.

When Should I Call My Healthcare Provider If I Have Upper Back Pain

Why Upper Back Pain is Different

Upper back pain usually gets better on its own. Call your healthcare provider if:

  • Your upper back pain doesnt improve after a week.
  • You develop any tingling or numbness in your legs or buttocks.
  • You have severe pain or muscle spasms.
  • You develop new symptoms such as fever, weight loss or bowel or bladder problems.

These may be a sign of a more serious condition.

A note from Cleveland Clinic

Upper back pain may not be as common as lower back pain, but it can still greatly affect your quality of life. While you cant always avoid upper back pain, there are ways to help prevent it. Make sure to stand up straight, get plenty of exercise and try to reduce your stress. If your pain doesnt improve, call your healthcare provider. They can help you figure out whats causing you pain and get you back on track.

Last reviewed by a Cleveland Clinic medical professional on 04/26/2022.


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How Do Doctors Diagnose The Cause Of Upper Back And Chest Pain

Your doctor may look for heart problems first. Diagnostic tests they may order include:

  • chest X-rays to look at the structures in your chest
  • ECG to look at your hearts rhythm
  • cardiac ultrasound to view your heart as it beats
  • angiogram to look at the blood flow in your heart
  • cardiac catheterization to look for any blockages in your blood vessels
  • stress test to see how your heart functions when stressed
  • blood tests to check for specific enzymes that may indicate heart damage

If the tests dont indicate a heart condition or if you have any other symptoms, your doctor will look for other possible causes. Other tests they may order include:

When Upper Back Pain Is Serious

Most cases of upper back pain are not due to a serious underlying cause, but rare cases may be caused by a progressing infection or illness, or from spinal instability that has started to affect a nerve root or even the spinal cord. In such cases, it is important to seek medical treatment immediately to reduce the risk of the problem becoming worse.

See Thoracic Spinal Nerves

Symptoms that could indicate a serious underlying cause of upper back pain include radiating pain or pins-and-needles tingling in the chest or abdomen, fever or chills, reduced coordination, problems walking, or severe headache. In addition, upper back pain that follows a high-impact event, such as an auto accident or fall from a ladder, should be evaluated by a doctor.

See When Back Pain May Be a Medical Emergency

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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.

Slouching in a chair over a desk may cause a loss of strength in the muscles. Over time, the weakening of muscles may lead to pain in the area as they experience strains or irritation.

When a person slouches, pressure from gravity and the body itself pushes on the spine, neck, discs, and ligaments. Over time, this pressure can lead to pain and other complications.

It is possible to condition the muscles to be stronger and more durable in most cases. This process starts with correcting the posture while sitting, and taking regular breaks from the desk to move around and stretch.

Exercises may also improve strength in the back, and using a standing desk can help, too.

Conditioning the muscle requires patience, however, and anyone with chronic upper back pain from weak muscles might benefit from seeing a physical therapist to find an exercise routine for their specific needs.

What If I Dont Want Surgery For My Back Pain

7 Upper Back Stretches For Pain Relief

Fortunately, most people with back pain dont need surgery. We usually take a conservative approach first, using a wide variety of nonsurgical spine treatments, said Dr. Guo. For example, I might send you to physical therapy or chiropractic therapy. I might recommend medications such as anti-inflammatories, muscle relaxants, or some nerve-pain medications. We offer injection therapy, including epidural injections, joint injections, and nerve blocks and ablation if your back pain fails to improve with the conservative treatments. Chances are, one of these approaches will help reduce your back pain and improve your function and quality of life.

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When Should I Start Exercising After Injury

Getting back to exercise too soon can worsen an injury, making your recovery process even longer. Therefore, its important to allow your injury to heal and slowly return to your regular activities.

Its best to avoid exercise until youve noticed improvements in your pain, stiffness, and swelling.

A good sign is when youre able to perform normal household tasks and daily activities with little to no pain and have full or almost full range of motion.

If youre unsure, its best to talk with a healthcare professional before starting any exercise.


Its best to avoid exercise until your pain, stiffness, and swelling have improved. Exercising too soon can worsen your injury and prolong your recovery process.

Warning Signs You Should See A Chiropractor For Upper Back Pain

Nov 6, 2019 | Uncategorized

Back pain is the biggest contributor to disability in the world and the reason most people miss work. And it affects everyone, from kids to the elderly. So, if youre experiencing back pain, youre not alone.

And if youre thinking of seeing a chiropractor for upper back pain, youre on the right track.

Medical studies give a big nod to the manipulation of the spine as the first line of care. Its shown to be as effective as medical care and exercise and a conservative choice if the pain moves a tad down the spine the only non-drug thats safe and effective.

But how do I know when to see a chiropractor for back pain, you ask?

To help, weve put together seven signs to look out for thatll tell you if its time to get into the chiropractic office. Keep reading to learn about and spot these easy red flags.

Then, if youre experiencing one or more of these warning signs, make an appointment so that you can get the all-natural pain relief and healing you need so you can get back to your happy, thriving life!

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What Else Should I Do

While its important to include neck and back exercises in your routine, youll want to include a variety of strengthening exercises for well-rounded fitness.

In particular, having a strong core has been linked to reduced lower back pain because the core is involved in stabilizing the spine. The core includes the following muscles (

11 ).

Additionally, you may benefit from other at-home treatments or professional therapies such as heat therapy , whole-body stretching, over-the-counter pain medications , massage therapy, and acupuncture.

Finally, if you work at a desk, try to set up your space ergonomically, which may help alleviate pain and pressure on your neck and back .


Having a strong core may help to reduce lower back pain. You may also benefit from at-home treatments or professional therapies such as heat therapy, over-the-counter pain medication, massage, or acupuncture.

Pain Moves From Your Chest To Your Back

Upper Back Pain

One potential cause of back pain is a condition called costochondritis, an inflammation of the cartilage connecting your ribs to your breastbone. While lifting heavy items, respiratory infections, and chest injuries can cause it, often the source of the pain is unclear. You may feel pain that travels from your chest to your back. Definitely get checked out by your doctor, it often goes away without any treatment.

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When Should I See A Doctor For Back Pain

When your back first starts to hurt, try taking an over-the-counter pain reliever and applying ice in the first 48 hours. You may apply heat after 48 hours. You may need to take it easy for a while, but its best to stay as active as tolerated, and to avoid absolute bed rest, said Dr. Guo.

If your back pain lasts more than two weeks and keeps you from participating in normal, daily activities, see your family doctor. If your pain is severe, you should see a doctor sooner. You should seek urgent medical care if you have:

  • Fever associated with back pain
  • Back pain after trauma
  • Loss of bladder or bowel control
  • Loss of strength in your arms and legs
  • Unexplained weight loss associated with back pain

Also, always be more cautious if you have special risk factors for cancer, infection, or fractures that may affect the spine.

Traumatic Back Injuries & Thoracic Spine Discomfort

Traumatic injuries to the spine can also lead to upper back pain. Here are a few examples of events that can precipitate an upper back injury:

  • Slip and fall accidents
  • Improper lifting technique
  • Overdoing it during a workout routine

Sometimes, an upper back injury is both obvious and immediate, with pain appearing right after the incident takes place. In other instances, pain may not fully emerge until the next day. These injuries can be rather severe, leading to a cascade of complications. For example, a fractured thoracic vertebra may eventually lead to chronic pain, nerve damage, or paralysis.

While examining you, your doctor should consider back injuries as a potential diagnosis, as doing so will ensure that you receive the correct treatments. Depending on the nature of your ailment, your doctor may refer you to a physical therapist to encourage your injuries to heal properly. In some cases, your doctor may refer you to a specialized surgeon if your condition warrants immediate attention.

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Causes Of Upper Back Pain

The course of upper back painand how to treat itdepends on the underlying cause of the condition. Even in cases where it seems obvious what started the upper back pain, such as an injury from a fall, the specific source of pain within the body can sometimes remain elusive.

Regardless of whether the exact source of upper back pain can be determined, it helps to know the various potential causes in order to better narrow down which treatments may be best.

How Do Doctors Diagnose The Cause Of Upper Back Pain

When to See a Doctor for Back Pain

To diagnose the cause of your upper back pain, your doctor will ask you several questions about your pain including:

  • When did your upper back pain start?

  • Can you describe your pain? Is it sharp, dull, achy or burning?

  • On a scale of 1 to 10 with 10 being the worst pain ever, how would you rate your pain?

  • Is your upper back pain on the left side, right side, or both sides?

  • Is your upper back pain constant or does it come and go?

  • What, if anything, makes your upper back pain better or worse?

  • Are you experiencing any other symptoms, such as weakness or numbness?

  • Does your upper back pain wake you at night or limit your activities during the day?

  • Have you ever injured your back?

  • What do you do for work?

  • Do you exercise?

Your doctor will also perform a physical exam, feeling your back for areas of tenderness or abnormalities. You may need to move your arms, reach in different directions, bend and change positions. Your doctor will want to know if movement affects your pain or if pain limits your movements. Your doctor may also test your muscle strength and reflexes.

In some cases, testing may be necessary including:

  • Blood tests to check your blood cell counts and electrolytes

  • Bone scans if osteoporosis or a bone tumor is a possibility

  • Imaging exams, including X-rays, CT scans, and MRIs

  • Nerve studies to evaluate how well your nerves and muscles are working

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Am I Likely To Get Back Pain

Several factors can increase your chances of having upper and middle back pain. Among them:

  • Age.Back pain starts for most people in their 30s or 40s, and itâs more common the older you get.
  • Being out of shape. The stronger the muscles in your back, shoulder, and abdomen, the lower your chance of injury.
  • Weight. If you carry extra pounds, you put more strain on your back.
  • Underlying conditions. Diseases such as arthritis and cancer can cause back pain.
  • Smoking. Smokerâs cough can strain your back. And if you smoke, you may be slower to heal, which can make your back pain last longer.

Where To Start With Back Pain

Low back pain is one of the most common complaints on the planet.

And when someone starts experiencing back pain it can be so frightening that we immediately want an expert that will somehow magically get rid of it.

Unfortunately, there’s just no unicorns and rainbows when it comes to solving back pain.

Realize that most back pain will resolve on its own. What I’m saying here is that your major ache or tweaked out back doesn’t require a specialist in most cases.

Some of the most common causes of acute or sudden back pain include an injury:

  • to a muscle or tendon
  • to a back ligament
  • to a bulging disc .

And the reality is, many of these issues will eventually resolve on their own.

In my personal opinion, the first time someone starts to experience back pain, they should immediately start doing back extension exercises.

I would continue to do back extensions every 3-4 hours throughout the day for at least 3 days.

And if you notice that you’re feeling better, continue for another 1-2 weeks.

But if your low back pain doesn’t improve, then maybe there is something more serious happening.

More serious causes of back pain include:

  • a narrowing of the spinal canal
  • disc tears or herniations
  • severe degenerative disc disease
  • spinal infections

So if your back pain doesn’t improve with back extensions and modified activities, then you’d want to consider someone who is qualified to properly assess the situation.

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Youve Had Enough Of Managing Your Upper Back Pain

If youve experienced persistent pain or discomfort in your upper back for a while but have just tried to manage it on your own, its time to reassess. This is especially true if youre struggling with the pain and its wreaking havoc on your happy life.

If its causing you to miss work, school, or fun activities, you need to find a way to treat your back and get to the source to heal it.

Fair enough if you want to see if itll go away on its own, but if its been six-plus weeks to two months of pain, get thee to a chiropractor. It may not be an emergency, but its your life.

And if the pain is getting worse, it could lead to an emergency so go have it checked. Youre sure to enjoy the relief you get either way.

Solving The Back Pain Puzzle One Spine Area At A Time

Upper Back Pain Causes and Treatments

When your back hurts, it can affect all aspects of your life from working at home or in the office to playing golf on weekends or even doing household chores. Daily activities such as driving, climbing steps, and sleeping become a struggle.

Pinpointing the source of your pain and designing an effective treatment plan begins with the knowledge that it may not be your back at all that is causing the problem.

Muscle tension, microtears in tendons or ligaments, and joint injuries from the shoulders to the hips and knees can cause pain throughout the spine. Even medical conditions such as gallbladder disease and kidney stones can initially present with back pain.

Unfortunately, misdiagnoses can cost patients time, energy, and money for procedures that might not address the root cause of their symptoms. The back pain experts on UT Southwesterns Spine Center and Physical Medicine and Rehabilitation teams often meet with patients whove had multiple back surgeries elsewhere, only to discover that a joint or musculoskeletal problem was to blame all along.

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