Upper back pain: All you need to know

Upper back pain describes pain in the part of your back that runs from the base of your neck to the bottom of your ribcage - an area known as the thoracic spine. 

What is upper back pain? {#introduction}

What causes upper back pain? {#causes}

When should I see a doctor urgently?

How is the cause of upper back pain diagnosed? {#diagnosis}

How is upper back pain treated? {#treatment}

How can I prevent upper back pain in future?

## What is upper back pain? {#introduction}

Upper back pain describes pain in the part of your back that runs from the base of your neck to the bottom of your ribcage - an area known as the thoracic spine. It most commonly affects the area between the shoulder blades, but it’s possible to get it in other parts of your upper back.

Upper back pain is less common than lower back pain, but like lower back pain, it’s usually nothing to worry about and gets better on its own in time. 

In some cases, however, it may have a more serious cause that needs urgent medical attention. 

You should see a doctor if you have upper back pain and you:

- recently had a fall or an injury to your back, or the pain started after a serious accident
- lifted something heavy
- have osteoporosis, a weakened immune system or you’ve had cancer
- have a fever, have lost weight without meaning to or you’ve recently had a bacterial infection
- are younger than 20 or older than 50 
- have numbness, weakness or tingling in your legs or around your genitals and buttocks
- have trouble controlling when you poo or pee
- have noticed that the pain doesn't get better after resting or is worse at night
- can’t do your daily activities (including sleeping) 
- have chest pain, or the pain feels worse when you cough, sneeze or poo
- the pain is coming from the top of your back, between your shoulders, rather than your lower back
- feel unwell, have a fever or have a swelling in your back

## What causes upper back pain? {#causes}

Lots of things can cause upper back pain. This includes activities that can irritate or injure muscles and other tissues in the area. Such activities include:

- whiplash or sports injuries
- poor posture
- weak back muscles
- carrying a backpack
- a muscle or ligament strain
- sitting at a computer for long periods of time
- making repetitive movements

In some cases, upper back pain is caused by a medical condition, like:

- [slipped disc](/health-library/conditions/slipped-disc)
- [osteoporosis](/health-library/conditions/osteoporosis)
- [spinal stenosis](/health-library/conditions/lumbar-spinal-stenosis) (narrowing of the space around the spinal cord (the spinal column)
- [osteoarthritis](/health-library/conditions/osteoarthritis)
- [ankylosing spondylitis](/health-library/conditions/ankylosing-spondylitis)


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## When should I see a doctor urgently?

For many people, upper back pain is not caused by anything serious and gets better over time. But sometimes, it can be a sign of a more serious condition.  See a doctor immediately if you have:

- chest pain
- a high temperature
- unintended weight loss
- tingling or numbness around your buttocks or genitals
- difficulty peeing or controlling when you pee or poo
- a swelling or change in the shape of your back

You should also see a doctor immediately if your pain:

- is so bad you're struggling to sleep or manage day-to-day tasks
- started after a serious accident, like a car accident
- gets worse when you sneeze, cough or poo
- doesn't get better after resting
- is worse at night
- is coming from the top of your back, between your shoulders


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## How is the cause of upper back pain diagnosed? {#diagnosis}

If you see a doctor for upper back pain, they will usually examine your back. They may also ask how bad your pain is, how long you've had it, and if anything may have triggered the pain (for example, playing sport or lifting something heavy).

The doctor will usually want to know if your pain is there all the time, if it comes and goes, and if it's getting better, staying the same, or getting worse over time.

Your doctor may be able to explain the cause during the consultation or they may also refer you for tests.

It’s common for a doctor to find no single specific cause for your upper back pain.


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## How is upper back pain treated? {#treatment}

If you have upper back pain that’s caused by a specific condition, a doctor will usually aim to treat the underlying problem. This treatment may involve taking medication, seeing a physiotherapist, or having injections or a type of hands-on therapy.

But most of the time, upper back pain doesn't have a serious cause, and doesn’t need medical treatment. Instead, it gets better by itself within a few weeks or months.

You can help reduce the pain by:

- [stying as active as possible](/health-library) – keeping very still and resting for long periods is likely to make the pain worse
- trying gentle, low-impact activities, like swimming, walking or yoga
- using hot or cold packs on the painful area – a hot water bottle or a bag of frozen vegetables wrapped in a towel also work well
- taking simple [painkillers](/painkillers/summary) – speak to your pharmacist for advice on how to safely get and use these medicines

You may also need to make some changes to your day-to-day life while your back recovers.

If your work involves a lot of lifting or bending, you may need to switch to different duties until your back feels better. If you work mainly at a desk, you may need to take more regular breaks.


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## How can I prevent upper back pain in future?

There are a few things you can do to help reduce your risk of upper back pain – especially upper back pain that’s caused by muscle strain. Try to:

- avoid activities that make your back hurt
- [exercise regularly](/health-library)
- [lose weight if you’re overweight](/health-library)
- [do stretches and muscle strengthening exercises often](/health-library)
- [improve your posture](/health-library)
- [lifting heavy objects safely](/health-library)

Upper back pain isn’t the only type of pain that can affect your back. Find out [other types of back pain and how to manage them](/health-library).

### Key points

- your upper back is the region from the base of your neck to the bottom of your ribcage
- most of the time, upper back pain isn’t caused by anything serious
- if you have upper back pain and any of the more serious symptoms described above, see a doctor as soon as possible
- resting for long periods is likely to make back pain worse, so stay as active as you can
- you can reduce your chances of upper back pain in future by improving your posture, exercising often and learning how to lift and carry safely

**References**

1. Your.MD. The best ways to treat upper back pain (accessed 30 September 2020). Available [here](https://www.livehealthily.com/back-pain).
2. NHS. Overview - Back pain (accessed 30 September 2020). Available [here](https://www.nhs.uk/conditions/back-pain/).
3. Peter J. Moley. Low Back Pain (accessed 30 September 2020). Available [here.](https://www.msdmanuals.com/home/bone,-joint,-and-muscle-disorders/low-back-and-neck-pain/low-back-pain)
4. NHS. Overview -Cartilage damage (accessed 30 September 2020). Available [here](https://www.nhs.uk/conditions/cartilage-damage/).
5. Natalie Heaton, Specialist Health Editor, Bupa Health Content Team. Upper back pain (accessed 30 September 2020). Available [here](https://www.bupa.co.uk/health-information/back-care/upper-back-pain).
6. Health and Safety Executive, Manual Handling At Work: A Brief Guide - 01/20 INDG143(rev4) (accessed 30th September 2020). Available [here](https://backcare.org.uk/wp-content/uploads/2020/04/indg143rev4.pdf).

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References

Dr Lauretta Ihonor

Healthily's medical team

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Upper back pain describes pain in the part of your back that runs from the base of your neck to the bottom of your ribcage - an area known as the thoracic spine.