Upper back pain: Causes, symptoms, treatment, prevention

Upper back pain is not anything to laugh about.

So many individuals suffer from this bothersome condition, and it’s important to understand the symptoms, causes, and available therapies for upper back pain.

In this post, we’ll go deeply into upper back pain, covering everything from its frequent causes to successful treatments.

What causes upper back pain?

Numerous things, from routine habits to underlying medical issues, might cause upper back pain. Let’s examine some of the main reasons for upper back discomfort in more detail:

Poor posture

The muscles and ligaments in the upper back can get strained by slouching, hunching over a phone or computer and other bad posture practices, which can cause pain and discomfort [1].

Over time, poor posture can also lead to spinal misalignment, which might lead to more discomfort and concerns.

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Overuse or strained muscles

The muscles and ligaments in the upper back might get strained or overused by repetitive motions, hard lifting or engaging in activities to which your body is not used. Pain, inflammation, and muscular spasms may result from this.

Slipped or herniated disc

The vertebrae that make up the spine are separated by cushioning discs. These discs can move out of position or sustain an injury that puts pressure on surrounding nerves, causing discomfort that might radiate to the upper back, shoulders, or arms [2].

Osteoarthritis

Osteoarthritis. is a chronic condition that affects the joints’ cartilage, causing it to deteriorate over time. This can result in discomfort, stiffness, and decreased mobility in the upper back when it happens in the facet joints of the spine.

Osteoarthritis
Photograph: nansanh/Envato

Injuries or fractures

The upper back’s bones, muscles, or ligaments might be fractured or injured due to trauma from a fall, automobile accident, sports injury or other accidents. This may result from significant discomfort, edema, and a restricted range of motion.

Myofascial pain syndrome

Myofascial pain syndrome, a chronic pain condition, affects the fascia, the connective tissue surrounding the muscles. In the upper back, trigger points—tight knots of muscle fibers—can form due to this disease, resulting in discomfort and stiffness.

Fibromyalgia

A chronic pain condition called fibromyalgia causes widespread discomfort and painful spots all over the body, including the upper back. Although the precise etiology of fibromyalgia is unknown, a mix of genetic, environmental and psychological factors are considered responsible [3].

Thoracic spine conditions

Upper back discomfort may result from specific thoracic spine (middle and upper part of the spine) diseases. Examples include spinal stenosis (a narrowing of the spinal canal), ankylosing spondylitis (a kind of arthritis affecting the spine) and scoliosis (an abnormal curve of the spine).

Referred pain

Upper back discomfort can occasionally be the consequence of pain coming from the neck, shoulders or even internal organs like the lungs or heart. Referred pain is a phenomenon that happens when the nerves that send pain signals get jumbled up or confused.

What are the symptoms of upper back pain?

Recognizing the signs of upper back pain is essential for prompt treatment and early intervention. Depending on the underlying reason, symptoms might vary, but there are certain typical warning signs to watch out for.

Here are a few of the more common signs and symptoms of upper back pain:

Sharp or acute upper back ache

A dull, ongoing discomfort and a sudden, stabbing feeling are common manifestations of upper back pain. Depending on the origin and seriousness of the problem, several types and levels of pain may be experienced.

For instance, a herniated disc or pinched nerve may cause intense shooting pain, but muscular strain or overuse may provide a dull ache.

Tightness or stiffness

There may be tightness or stiffness in the muscles around the upper back. Your range of motion may be restricted, making it challenging to carry out regular tasks and engage in physical activity. Stiffness could be more apparent when you first get up in the morning or after spending a lot of time sitting still.

Spasms of muscles

Upper back discomfort occasionally causes muscular spasms, which are uncontrollable contractions of the muscles [4]. These spasms can hurt and could worsen the pain or discomfort in the afflicted area temporarily.

Pain that becomes worse as you move

While you move, especially while performing tasks that require twisting, bending or lifting, upper back discomfort may get worse. A medical expert should be consulted to determine the cause of any pain that worsens with movement, which might indicate a herniated disc or another more serious problem.

Radiating discomfort in the arms, shoulders or neck

Aches and pains in the upper back might occasionally spread to the neck, shoulders or arms. Nerve compression or referred pain, in which the brain interprets pain signals from another region of the body incorrectly, maybe the source of this [5].

Tingling, numbness or weakness

Numbness, tingling or weakness in the arms or legs and upper back discomfort might indicate nerve compression or injury. To avoid future difficulties, this should be examined by a medical practitioner as soon as feasible.

Respiratory issues or shortness of breath

In certain circumstances, respiratory problems or shortness of breath may also accompany upper back discomfort. This may indicate a more serious condition that needs quick medical treatment, such as a lung or heart disorder.

When to see a doctor if you have upper back pain?

While self-care and home remedies can frequently relieve upper back discomfort, there are times when seeing a doctor is required to guarantee a correct diagnosis and course of therapy.

When experiencing upper back discomfort, it’s imperative to see a doctor under the following circumstances:

Constant or escalating discomfort

It’s crucial to consult a doctor if your upper back discomfort lasts over a few weeks or worsens over time. A herniated disc, arthritis, or a spinal disease are a few conditions that might cause persistent discomfort and call for medical attention.

Extreme pain

If your upper back discomfort is severe and interfering with your everyday activities or ability to sleep, it’s time to see a specialist [6]. A more serious problem that needs immediate medical attention may be indicated by severe pain.

extreme pain
Photograph: LightFieldStudios/Envato

Tingling, numbness or weakness

Along with upper back discomfort, numbness, tingling or weakness in your arms or legs may be a sign of nerve compression or injury. A medical expert should analyze this as quickly as possible to rule out any additional issues and decide on the best action.

Connected symptoms

If additional symptoms like fever, unexplained weight loss, or night sweats accompany your upper back discomfort. These signs might point to a more serious underlying problem, including an infection or a systemic disease.

Self-care has not improved

It’s a good idea to see a doctor if your upper back discomfort does not get better with over-the-counter painkillers, rest, ice or heat treatment. They can suggest more efficient treatment alternatives and assist in identifying the source of your discomfort.

How is upper back pain diagnosed?

The diagnosis of upper back pain is made by healthcare professionals using a variety of techniques and instruments, and it often entails a combination of the following:

Medical background

Evaluating your medical history is typically the first step in the diagnostic procedure. The start, length, severity and kind of your pain will be discussed with you by your doctor, along with any accompanying symptoms.

They could also ask you about prior accidents, illnesses and lifestyle choices that may have contributed to your upper back discomfort.

Physical examination

Your doctor will evaluate your posture, range of motion and spinal alignment during the physical exam. Additionally, they will assess your muscular strength and neurological function and look for any trigger points, spasms or sore spots in your muscles. This may entail evaluating your reflexes, sensitivity and arm and leg muscular strength.

Imaging studies

Your doctor can suggest imaging tests to get a clear picture of your spine and the structures around it if they suspect an underlying problem, such as a herniated disc, fracture or spinal condition. Typical imaging exams include:

  • X-rays

These show the bones and joints in your spine in two dimensions, making it easier to spot problems like fractures, arthritis or spinal misalignments.

  • Magnetic Resonance Imaging (MRI)

An MRI produces fine-grained pictures of the soft tissues, such as muscles, ligaments and nerves, using magnetic fields and radio waves. This can aid in diagnosing soft tissue problems like herniated discs and nerve compression.

  • Computed Tomography (CT) Scan

A CT scan combines many X-ray pictures to provide a more in-depth, three-dimensional image of your spine. This can be used to detect problems like spinal stenosis or fractures.

Additional tests

Your doctor can occasionally prescribe extra testing to assess your symptoms or rule out certain illnesses. These tests might consist of:

  • Blood tests: These may be used to spot indications of infection, inflammation, or other systemic problems that may be causing upper back discomfort.
  • Electromyography (EMG) and Nerve Conduction Studies (NCS): These procedures may assess muscle activity and nerve function, which can help identify nerve compression or injury.
  • Bone scans: A small quantity of radioactive material is injected into your circulation to do a bone scan. This radioactive material then accumulates in the more active bone tissue, such as that around fractures or infections. The radioactive substance is then detected by a specialized camera, which produces a clear image of your bones [7].

What are the available treatment options for upper back pain?

The course of treatment for upper back pain will vary based on the underlying cause, degree and specific requirements of each patient.

To successfully address upper back pain, a mix of conservative therapies, drugs and lifestyle modifications is frequently advised. More intrusive treatments can be required in some circumstances. 

Here is a deeper look at some typical upper back pain remedies:

1. Conservative treatments

Most non-invasive methods used in conservative therapy for upper back pain include:

  • Rest

Allowing your upper back time to heal by avoiding activities that worsen your discomfort might be a crucial step in the healing process.

  • Ice and heat therapy

Heat treatment can assist in relaxing muscles and enhance blood flow to encourage healing, while cold packs applied to the afflicted region can help reduce inflammation and relieve discomfort.

  • Physical therapy

To strengthen and stabilize the muscles in your upper back, increase flexibility and restore function, a physical therapist can create a customized exercise and stretching program.

  • Massage therapy

A massage helps ease tense muscles, lessen discomfort, and enhance blood flow to the injured area.

2. Medications

Your doctor may advise using one of the following drugs to treat your upper back pain, depending on the nature and severity of the problem:

  • Over-the-counter pain relievers

Nonsteroidal anti-inflammatory medicines (NSAIDs), including ibuprofen and naproxen, can help decrease inflammation and relieve discomfort [8].

  • Painkillers on prescription

In circumstances of extreme pain, your doctor could recommend stronger painkillers, such as opioids, for short-term usage.

  • Muscle relaxants 

These drugs can ease the tension and muscle spasms brought on by upper back discomfort.

  • Topical pain relievers

Topical painkillers can be administered directly to the painful location to reduce discomfort. These products include creams, gels, and patches.

3. Lifestyle changes

Making the following modifications to your way of life will help you manage upper back pain and stop it from coming back:

  • Maintain proper posture

Maintain good posture by sitting and standing straight, pushing your shoulders back, and positioning your head so that it is parallel to your spine. To support excellent posture, use furniture and equipment that has been ergonomically built.

  • Exercise regularly

Exercise frequently to maintain your muscles balanced, strong, and flexible. Combine aerobic, strength, and flexibility activities.

  • Manage stress

Use stress-reduction methods like yoga, meditation, or deep breathing to ease muscular tension and avoid upper back discomfort.

4. Alternative therapies

Alternative treatments for upper back discomfort can help some people, including:

  • Acupuncture

This traditional Chinese medicine uses tiny needles to stimulate healing by placing them into certain body sites.

acupuncture
  • Chiropractic treatment

To assist restore spinal alignment and ease pain, chiropractors employ manual adjustments and spinal manipulation procedures.

  • Mind-body techniques

By teaching you how to focus your attention and increase your awareness of your body’s feelings, techniques like meditation, biofeedback and guided imagery can help you manage pain.

5. Invasive treatments

More intrusive procedures may be required in rare situations where conservative therapies and lifestyle modifications have failed to relieve symptoms:

  • Injections

Corticosteroid injections or nerve blocks may treat the affected area’s pain and inflammation.

  • Surgery

In extreme situations or where there is considerable nerve compression or injury, such as herniated discs or spinal stenosis, surgical intervention may be required.

How can I prevent upper back pain?

Addressing the probable causes of upper back discomfort and forming healthy behaviors that support your spine and surrounding muscles are two ways to prevent it. The following advice can help you avoid upper back pain:

1. Keep a good posture

You must practice good posture to keep your spine healthy and avoid upper back discomfort. Maintain a straight posture while sitting and standing, with your shoulders back and your head level with your spine.

Use back-supporting ergonomic furniture and equipment when sitting for extended periods and take pauses to stand up and stretch [9].

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2. Stretch and build up your muscles

Exercise the muscles in your upper back, shoulders and core on a daily basis. Your spine is supported by these muscles, which you may strengthen to lessen muscular imbalances and injury risk.

Stretching exercises should be a part of your routine to increase flexibility and avoid muscular stiffness.

3. Lift objects properly

Use the right lifting techniques to safeguard your upper back while moving large goods. As you lift, bend your knees slightly while maintaining a straight back and using your core muscles to stabilize your spine.

Hold things close to your body and avoid rotating your body when lifting to lessen the tension on your back muscles.

4. Keep a healthy weight

The likelihood of experiencing upper back discomfort might increase if you carry extra weight since it puts more strain on your muscles and spine. Try to keep your weight in check by eating a balanced diet and getting frequent exercise.

5. Reduce stress

Upper back discomfort and muscular tightness are both influenced by stress. Practice stress-reduction methods including deep breathing exercises, meditation, yoga, or relaxing activities.

6. Get enough rest

Your spine’s natural curvature can be preserved and your chance of developing upper back discomfort can be reduced by using a supportive mattress and pillow while you sleep.

Avoid sleeping on your stomach as it might strain your neck and upper back. Choose to sleep on your side or back; you may want to use a cushion beneath or between your knees to keep your spine properly aligned.

7. Be active

Your muscles are kept strong, flexible and less prone to injury with regular physical exercise. To enhance total spinal health, blend aerobic, strength-training and flexibility workouts into your program.

How long does upper back pain usually last?

Depending on the reason, degree and success of the treatment used, the duration of upper back pain might vary greatly. According to various conditions, the following basic summary of how long upper back discomfort could endure is provided:

Acute upper back pain

Acute upper back pain commonly develops due to muscular injuries or overuse and subsides within a few days to weeks. Most of the time, conservative therapies for acute pain include rest, ice and heat therapy, over-the-counter painkillers and mild stretching exercises.

Chronic upper back pain

Chronic upper back discomfort lasts for prolonged intervals, frequently three months or more. An underlying issue like a herniated disc, degenerative disc disease or arthritis might cause this discomfort [10].

The efficacy of the treatment regimen, which may involve physical therapy, drugs or more intrusive procedures like injections or surgery, determines how long persistent upper back pain lasts.

Recovery period following therapy

Depending on the individual’s response to the treatment and the underlying cause, the recovery period for upper back pain might vary greatly following treatment.

For instance, individuals who receive physical therapy could feel better in a few weeks, but those who need surgery might take many months to recover completely.

How should I sleep to avoid upper back pain?

A nice night’s sleep and the prevention of upper back discomfort may be achieved by sleeping in the optimal position and utilizing the right support. Here are some suggestions for avoiding upper back discomfort as you sleep:

1. Select the right mattress

You need a supportive mattress for your spine to stay in its natural posture while you sleep. Find a mattress with the ideal amount of firmness and softness to offer your body the support it needs.

For most people, a medium-firm mattress is frequently advised since it can conform to the body’s natural contours while providing support.

2. Choose the right pillow

A decent cushion should preserve the natural curve of your spine while supporting your neck and head. Take into account your favorite sleeping position while selecting a pillow:

  • Back sleepers

For back sleepers, choose a pillow that supports the natural curvature of their neck without elevating or lowering their heads excessively.

  • Side sleepers

For side sleepers, pick a cushion with appropriate height to bridge the space between their shoulder and neck, preserving their spinal alignment.

3. Adopt the proper sleeping position

Your sleeping posture is very important for avoiding upper back pain:

  • Back sleeping

Sleeping on your back is the best posture for preserving spinal alignment because it uniformly distributes your weight across the mattress. Place a small cushion beneath your knees to keep your lower back’s natural curvature.

  • Side sleeping

Sleeping on your side might help you keep your spine properly aligned. Place a cushion between your knees to stop your upper leg from dragging your spine out of alignment.

Avoid lying on your stomach since the unusual twist it causes in your spine might strain your neck and upper back.

4. Maintain a regular sleeping schedule

A regular sleep schedule can improve general health and lower the risk of upper back discomfort. Try to sleep for 7 to 9 hours every night and wake up simultaneously every day, including on the weekends.

5. Stretch before going to bed

Before bed, do gentle stretches to loosen up your muscles and reduce upper back strain. Include neck, shoulder and upper back exercises to help you relax and lower your chance of experiencing pain while you sleep.

Closing thoughts

Recognizing the many reasons for upper back discomfort is the first step in managing it, whether they be a muscular strain, poor posture, stress or more serious conditions like ruptured discs or degenerative illnesses. Finding the proper diagnosis and therapy for upper back pain begins with awareness of its symptoms.

Ultimately, it all comes down to encouraging spinal health, leading a balanced lifestyle, and taking proactive steps to identify and treat upper back discomfort as soon as it arises. After all, you support yourself in all parts of your life, so you should support your back too!

FAQs

Should I be worried about upper back pain?

You should seek emergency medical help if your pain is severe, persistent, accompanied by other symptoms like chest discomfort, breathing problems or abrupt weight loss, or if it doesn’t go away with rest and self-care techniques. 

The presence of other symptoms, such as chest pain or discomfort, shortness of breath, cold chills, dizziness, nausea or discomfort in the arms, jaw, neck or stomach, indicates that your back pain is heart-related. Back pain caused by the heart is frequently abrupt and might feel distinct from regular back pain; it may feel acute, searing or constricted.

Can acid reflux cause back pain?

Yes, back discomfort may result from acid reflux. Burning or pain may spread from the chest to the back due to this ailment, commonly known as gastroesophageal reflux disease (GERD). A common name for this is heartburn. 

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[1] https://www.itnycpt.com/blog/poor-posture-main-culprit-behind-muscle-tension/
[2] https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc
[3] https://medlineplus.gov/ency/article/000427.htm
[4] https://my.clevelandclinic.org/health/diseases/15466-muscle-spasms
[5] https://www.spine-health.com/conditions/upper-back-pain/all-about-upper-back-pain
[6] https://www.cdc.gov/bloodpressure/sleep.htm
[7] https://www.mayoclinic.org/tests-procedures/bone-scan/about/pac-20393136
[8] https://my.clevelandclinic.org/health/drugs/11086-non-steroidal-anti-inflammatory-medicines-nsaids
[9] https://www.spine-health.com/wellness/ergonomics/posture-straighten-your-back
[10] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/back-pain-disc-problems

Photograph: nansanh/Envato
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