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Why Do I Have Upper Back Pain

Consider Your Arm Swing

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Think about your arm swing when you are running. Are they swinging too much? Or not enough? Try and focus on your fist being close to your hip as you swing your arm backwards, and then as your swing your arm forwards, your elbow being close to your hip. There will be some slight variance with this from person to person but any large differences may contribute to pain. Are your arms crossing over your body as you swing them or are they parallel to each other?

You may even find that after a few weeks of doing these exercises, your breathing during running may improve. Sometimes improving posture can actually help our lung capacity, meaning you can take deeper breaths and make the most of every one!

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.

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.

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Pain Intensifies When You Move

You had a recent fall, but you didnt think your back would hurt this much! If you had a traumatic injury, like a heavy object lands on your back or you slip on the ice and fall with your back striking the edge of a step, you can break a vertebral bone or a rib, notes Dr. Tien. The pain can be moderate to severe, but it will get worse when you move. Talk to your doctor, especially after any bad injury.

Other Possible Treatments Of The Upper Back Pain May Include The Following:

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  • Joint manipulation and manual movement is done under the guidance of a certified medical professional like a physiotherapist.
  • Set of exercises are given to the patient to be performed at home on a daily basis to lessen the stiffness and encourage movement around the affected area, the upper back.
  • Prescription of pain relievers may be prescribed by the attending doctor to lessen the patientâs pain or discomfort while undergoing any treatment therapy program.

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Questions Your Doctor May Ask About Upper Back Pain That Shoots Down The Arm

  • Turn your head toward the side of your body that is hurting. Lift your head up as someone else pushes down on your head. Does this cause greater pain in your upper body?
  • What is your body mass?
  • Do you feel a painful, tight knot or band in your muscle anywhere on the body?
  • What makes your back pain worse?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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

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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What Is The Upper Back

If you want to understand your upper back pain, start with an anatomy lesson.

Pain in the upper and/or mid back is less common than lower back or neck pain. One 2015 Mayo Clinic review of studies suggests that about a third of people get lower back or neck pain , compared to less than one-fifth reporting upper back pain.

The upper back is the region below the cervical spine and above the low back . The upper back is called the thoracic spine, and it is the most stable part of the spine. The range of motion in the upper back is limited because of the spines attachments to the ribs .

Think of your spine as a tree trunk. It keeps you standing upright. It connects parts of your skeleton to each other. It carries the weight of your upper body.

Since thats a massive job, the spine itself shares some of the physical load with nearby muscles, some of which include:

  • Trapezius: Near your shoulder blade, helps you stand straight and throw

  • Latissimus dorsi: Lower on your back, helps with arm movement and breathing

  • Rhomboids: Adjacent to trapezius, supports your shoulders and helps you pull

When you hurt your upper or mid back doing yard work or playing tennis, chances are high youve injured one of these muscles. The most common reason we see people with upper back pain is a simple musculoskeletal strain, says Reginald Knight, MD, Director of Bassett Spine Care Institute in Cooperstown, NY.

Prevention Of Upper Back Pain

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The following tips may help to prevent you from developing upper back pain.

  • Lift objects safely and correctly by bending at your knees and not from the waist.
  • Make sure your back is properly supported when sitting.
  • If you wake up with back pain, a more supportive mattress that adjusts to your back and supports its various curves and hollows may help.
  • Take regular breaks from sitting for long periods of time and from doing repetitive tasks.
  • Practise good posture see our section on causes of back pain.
  • Exercise regularly see our FAQ on some specific exercises for upper back strength.
  • Learn and practise good technique for any sports youre doing.
  • Stop doing any activity that you know is causing your back pain.
  • Stop smoking it can speed up the degeneration of the discs between your vertebrae that act as shock absorbers.
  • If you are overweight, losing weight may help to reduce the risk of back pain.

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Youre Short Of Breath

Rarely, upper back pain may be due to a punctured lung, which can be caused by an injury. While it is less likely to be the cause of your discomfort, a punctured lung is something you need to know the signs of so you can take the right action. If the pain is accompanied by shortness of breath or severe pain taking a deep breath, seek urgent medical care, advises Dr. Chang.

Fighting Infections With Antibiotics

For a lower UTI, a 3-7-day course of antibiotics helps treat the bacteria. Serious upper infections need hospitalization for IV antibiotics. This helps with the back pain, fever, and vomiting that happens. Once doctors get the fever under control, treatment will then move to oral antibiotics. The doctor will give a longer course of antibiotics for a secondary UTI. There are cases where antibiotics do not work or the UTI returns multiple times in a year. In these cases, consult a urologist to advise on next steps.

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What Upper Back Symptoms Warrant A Trip To The Doctor

Most bouts of upper back pain gradually go away on their own or with conservative at-home treatment . However, some symptoms are more serious than others and require swift medical attention.

  • Severe, persistent upper or mid-back pain that develops suddenly

  • Pain that is progressively worsening

  • Pain that hasnt gone away in a week

  • Pain that is interfering with your daily life

  • Pain that isnt responding to conservative treatment

  • Neurologic symptoms

In rare cases, upper back pain is indicative of a serious and/or painful medical problem, including lung cancer, kidney stones, or spinal infection.

Additionally, because the thoracic spine is linked to the ribs, some people with upper back pain report sharp pain when filling their lungs with air to take a deep breath. Though this symptom may be benign, it could also be a sign of a blood clot. If you feel faint, short of breath, or a spike in upper or mid-back pain when you take a deep breath, see your doctor immediately to rule out a potentially life-threatening pulmonary embolism.

Finally, its especially important to see a doctor after youve endured a traumatic injury, such as a fall. Even if you arent experiencing any back pain, you should be evaluated by a physician to ensure your spine did not sustain damage .

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.

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Change What You Sleep On

Who knew you could make so much progress toward relieving your back pain by simply just going to bed?

Make sure you have the right pillow.

You should be sleeping on a feather pillow or a memory foam pillow at night. These will adapt to the shape of your head and change shapes throughout the night as you move.

Firm pillows elevate your neck too high and that type of angle for a prolonged period is a common cause of neck pain.

Upper Right Back Pain Under Shoulder Blade

Muscle strain, sprains, and spasms can affect the rhomboid muscles, which are located in the middle of the shoulder blades. This pain is mostly felt in the middle of the upper back, but may radiate out to one or both sides.

Pain under or near your shoulder blade can make it hard to rotate your shoulder fully, or move your arm with full range of motion. This type of pain is often caused by muscle strain, resulting from overuse. It can also happen if you sleep in an odd position, or have poor posture.

If pain in or under the shoulder blade does not dissipate with home treatment within a few days, it may also signal more serious conditions in the lungs or gallbladder.

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What Is A Back Spasm

A back spasm is a painful involuntary and sustained contraction of one or more muscles of the spine. Runners may get a feeling of having a charley horse in their calf muscle. Thats what a back spasm feels like, but in a different part of the body, says Saad Chaudhary, MD, spine surgeon at the Mount Sinai Hospital in New York City.

A spinal muscle spasm could represent something serious, such as a microtear around a spinal disc that can generate enough inflammation to cause muscles to tense. In most cases, however, a muscle spasm in the back is a symptom of a mild muscle injury, such as a sprain, Dr. Choudhary says.

How Is Upper Back Pain Diagnosed

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Your healthcare provider will ask you questions about your medical history, activity level and symptoms. They will also ask you questions about your pain. These questions may include:

  • When did the pain start?
  • Where does the pain hurt the most?
  • Does anything you do make the pain feel better?
  • Does anything you do make the pain feel worse?

Your healthcare provider may do a physical exam. They may have you lift or bend your legs to see how moving affects your pain. Your healthcare provider may test your muscle strength and reflexes.

Depending on what your healthcare provider finds, they may order additional tests. These tests may include:

  • Spine X-ray: Uses radiation to produce images of the bones in your spine.
  • Magnetic resonance imaging scan: Uses a magnet and radio waves to create pictures of your bones, muscles, tendons and other soft tissues in your spine.
  • Computed tomography scan: Uses X-rays and a computer to create 3D images of the bones and soft tissues in the spine.
  • Electromyography : Tests the nerves and muscles in your spine and checks for nerve damage , which can cause tingling or numbness in your legs.
  • Blood test: Can detect genetic markers for some conditions that cause back pain.

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What Are The Recommended Treatments Or Drugs For Upper Back Pain

If the upper back pain is the result of a muscular strain, here are some home care remedies that can be done by the affected person. Cold compress application is performed on the affected area, either with the use of cold ice pack or any packet of frozen vegetables like frozen peas.

Over-the-counter pain relief medications may be used such pain relieving gel with an active ingredient of painkiller like ibuprofen is applied. Others use herbal type of gels to ease any pain or discomfort such as Arnica gel.

Muscle Spasms Of The Lumbar Spine

A spasm in the lower back is likely a contraction of the erector spinae muscles, a large group of stabilizing muscles that run on either side of the spine, or the latissimus dorsi, Dr. Chaudhary says. Commonly referred to as lats, theyre one of the largest muscle groups in the body, covering the middle and lower back.

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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:

When Should I Worry About Upper Back Pain

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Much of the time, upper back pain is not serious, but in some cases, it may be a sign of a medical issue that needs to be addressed.

See a doctor if the upper back pain is:

  • Sharp, rather than dull: Could be a sign of a torn muscle or ligament, or a problem with an internal organ in the back or side
  • Radiating to the buttocks or legs: may be a sign of nerve compression or damage
  • Associated with deep inhalations: could be a sign of an infection or blood clot in lung
  • Associated with pain in the chest or upper abdomen: could be a sign of problem with the aorta or gallbladder

Also see a doctor if you have upper back pain accompanied by any of the following symptoms or any of the following underlying conditions:

  • May be a sign of infection
  • Numbness or tingling
  • Can be a sign of a herniated disc, spinal stenosis, or sciatica
  • If left untreated, prolonged nerve irritation and damage can lead to permanent impairment
  • If numbness or tingling occurs in the groin or glutes, its called saddle anesthesia and is a sign of a serious nerve or spine condition
  • Sudden weakness in the legs
  • May be caused by compressed nerves
  • Sudden leg weakness could also indicate a stroke
  • Loss of bowel or bladder function
  • Can be a sign of a rare and serious condition called cauda equina syndrome, in which the nerve roots in the lower end of the spinal cord have become compresses and paralyzed
  • Cauda equina syndrome is a medical emergency that requires immediate attention
  • Foot drop
  • Pain at night
  • Prolonged pain
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