What are the most likely causes of sudden sharp pain in the upper back? What can cause upper back pain? How can you treat upper back pain?

9 Most Likely Causes of Upper Back Pain

Though it is less common than lower back pain or neck pain, a study posted to Occupational Medicine indicated that 1 in 10 men and 1 in 5 women might suffer from upper back pain. Doctors call upper back pain thoracic spine pain or TSP. Common causes include the following:

1. Muscle Deconditioning and Poor Posture

Using the muscles infrequently or incorrectly can cause back pain. 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. 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.

2. Muscle Overuse

Overusing back muscles is another common cause of upper back pain. This typically occurs due to repeating the same motions over time. This can be a cause of muscle strain, tightness, and irritation. The classic example of how this occurs is a pitcher in baseball, who does a similar motion every time they pitch, which can often take a toll on their shoulder. Other repetitive activities may cause similar pain. Someone who has to make the same motion all day, or lifts things above their head throughout the day, for example, may start to experience muscle irritation, tightness, or strain. This could turn into chronic pain if they ignore these signs. Treatment for muscle overuse typically begins with resting the area, as well as using heat or ice packs to promote blood circulation to the muscle tissues. It may help to find ways to avoid the repeated motion where possible or to take breaks between activities. A physical therapist may recommend exercises to promote flexibility and strength in the area.

3. Traumatic Injury

A traumatic injury can also lead to back pain. This may be the result of situations that include car accidents, slipping and falling, work-related accidents, lifting incorrectly, or working out too hard. The injury is sometimes obvious, and pain appears just after the incident. At other times, the pain may not develop until later or the next day. Traumatic injuries can be severe, and issues from injuries, for example, fractured vertebrae, put a person at risk of lasting complications, including chronic pain, nerve damage, and paralysis. A doctor should look at all potential back injuries as it is vital that they heal properly to avoid long-term pain. A doctor may refer the person to a physiologist or physical therapist to help muscle injuries heal properly. Severe injuries may require surgery.

4. Herniated Disc

Discs in the spine prevent the vertebrae from rubbing against each other. Herniated discs are more common in the lower back but may sometimes happen in the upper back too. Discs are the soft, rubbery cushions between each vertebra. Herniated discs occur when a piece of this cushion pokes through and puts pressure on the spine. Even a small amount of pressure can result in significant pain in the middle of the back, as well as other symptoms, including numbness or weakness in the arms or legs. Most people do not need surgery for herniated discs and will recover with rest or by taking anti-inflammatory medications.

5. Pinched Nerve

A herniated disc can slip far enough out that it compresses the nearby nerve. A pinched nerve in the middle back may cause numbness and pain in the arms or legs, problems with controlling urination, and weakness or loss of control in the legs. When a pinched nerve comes from a herniated disc, the treatment is similar to treating the herniated disc. A pinched nerve does not usually need surgery, though doctors may recommend spinal steroid injections in some cases.

6. Osteoarthritis

The source of back pain is sometimes not the muscles, but a problem in the bones and joints. The cartilage that cushions and protects the bones may wear down as a person ages. The term for this is osteoarthritis. It is common in the spine and can cause pain and stiffness in the upper back. Osteoarthritis is more likely to develop in older adults, though it can occur at younger ages as well. Treatment for osteoarthritis in the back typically involves over-the-counter pain medications, physical therapy, and sometimes steroid injections.

9 most likely causes of upper back pain

Though it is less common than lower back pain or neck pain, a study posted to Occupational Medicine indicated that 1 in 10 men and 1 in 5 women might suffer from upper back pain.

Doctors call upper back pain thoracic spine pain or TSP. Common causes include the following:

1. Muscle deconditioning and poor posture

Share on PinterestUsing the muscles infrequently or incorrectly can cause back pain.

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.

2. Muscle overuse

Overusing back muscles is another common cause of upper back pain. This typically occurs due to repeating the same motions over time. This can be a cause of:

• muscle strain
• tightness
• irritation

The classic example of how this occurs is a pitcher in baseball, who does a similar motion every time they pitch, which can often take a toll on their shoulder.

Other repetitive activities may cause similar pain. Someone who has to make the same motion all day, or lifts things above their head throughout the day, for example, may start to experience muscle irritation, tightness, or strain. This could turn into chronic pain if they ignore these signs.

Treatment for muscle overuse typically begins with resting the area, as well as using heat or ice packs to promote blood circulation to the muscle tissues. It may help to find ways to avoid the repeated motion where possible or to take breaks between activities.

A physical therapist may recommend exercises to promote flexibility and strength in the area.

3. Traumatic injury

A traumatic injury can also lead to back pain. This may be the result of situations that include:

• car accidents
• slipping and falling
• work-related accidents
• lifting incorrectly
• working out too hard

The injury is sometimes obvious, and pain appears just after the incident. At other times, the pain may not develop until later or the next day.

Traumatic injuries can be severe, and issues from injuries, for example, fractured vertebrae, put a person at risk of lasting complications, including chronic pain, nerve damage, and paralysis.

A doctor should look at all potential back injuries as it is vital that they heal properly to avoid long-term pain.

A doctor may refer the person to a physiologist or physical therapist to help muscle injuries heal properly. Severe injuries may require surgery.

4. Herniated disc

Discs in the spine prevent the vertebrae from rubbing against each other.

Herniated discs are more common in the lower back but may sometimes happen in the upper back too.

Discs are the soft, rubbery cushions between each vertebra. Herniated discs occur when a piece of this cushion pokes through and puts pressure on the spine.

Even a small amount of pressure can result in significant pain in the middle of the back, as well as other symptoms, including numbness or weakness in the arms or legs.

Most people do not need surgery for herniated discs and will recover with rest or by taking anti-inflammatory medications.

5. Pinched nerve

A herniated disc can slip far enough out that it compresses the nearby nerve. A pinched nerve in the middle back may cause:

• numbness and pain in the arms or legs
• problems with controlling urination
• weakness or loss of control in the legs

When a pinched nerve comes from a herniated disc, the treatment is similar to treating the herniated disc. A pinched nerve does not usually need surgery, though doctors may recommend spinal steroid injections in some cases.

6. Osteoarthritis

The source of back pain is sometimes not the muscles, but a problem in the bones and joints.

The cartilage that cushions and protects the bones may wear down as a person ages. The term for this is osteoarthritis. It is the most common form of arthritis among older adults, according to the United States National Institute on Aging.

Osteoarthritis may eventually lead to cartilage between the bones completely wearing away, causing the bones to rub together. This can also put pressure on the nerves in the spine, causing numbness or tingling in the arms and legs.

Anyone who suspects they have osteoarthritis should see a doctor for a diagnosis and treatment plan. Treatment typically focuses on managing pain and keeping the joints functioning.

7. Myofascial pain

Pain may also stem from problems in the connective tissue in the back, which doctors call the fascia.

Myofascial pain may begin after an injury or overuse, but chronic myofascial pain may last long after the initial injury.

It is still uncertain why myofascial pain continues in some cases. Doctors may recommend physical therapy and myofascial release therapy to enable a person to work the fascia and relieve the pain.

8. Spinal infection

In some cases, surgery may be necessary to treat a spinal infection.

Rarely, an infection may be the cause of upper back pain. A spinal epidural abscess is a collection of germs and pus that form between the spinal cord and bones of the spine.

The abscess can grow and swell, leading to pain. Early diagnosis is critical, and doctors will treat a spinal abscess quickly to avoid serious complications.

Antibiotics may help, and surgery may be necessary to clear the abscess and reduce the risk of complications.

A study posted to BioMed Research International notes that mortality can vary from 2 to 25 percent in people with spinal epidural abscess, typically, because it may take too long to diagnose their condition.

9. Lung cancer

Back pain may be due to lung cancer in very rare cases.

A case study in the Journal of the Advanced Practitioner in Oncology highlights one such case. The study notes that complications can cause the cancer to spread to the bones in about 30 to 40 percent of people with non-small cell lung cancer.

Specific conditions affecting the spine or muscles may also lead to upper back pain. These include:

• scoliosis
• fibromyalgia
• spinal deformity
• problematic kyphosis

Treatment for each condition varies and will have varying degrees of success.

It may not be possible to prevent all causes of upper back pain, but there are some easy steps people can take that may avoid some of the more common causes. These include:

• Take regular breaks from sitting or lying down to stretch and move different muscle groups.
• Take frequent breaks when working at a desk to stretch, so the muscles stay loose and strong.
• Take a few minutes to stretch the muscles or warm up the body before any activities.
• People who lift heavy objects should avoid twisting or lifting with their back.
• Have regular massages to help work out the tension of the muscles.
• Work with a physical therapist to strengthen weak muscles and keep pressure off the joints.
• Avoid wearing heavy backpacks or purses.
• Be conscious of posture at all times, walking upright and sitting correctly, using back supports if necessary.

Most cases of back pain appear because of lifestyle issues, such as weak or overused muscles from repetitive behaviors. In these cases, lifestyle changes, such as regular exercise and stretching, may help relieve pain.

In cases of trauma or chronic back pain, people should see a doctor for a proper diagnosis. Anyone who is uncertain where to begin should ask their doctor about their pain and treatment options. They may recommend specific exercises or refer a person to a physical therapist.

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When Should You Worry About Upper Back Pain?

If you spend any extended time hunched over a computer or phone, chances are you’ve experienced some form of upper back pain. While this part of the back (also known as the thoracic spine) is less susceptible to injury than the lower or middle back, upper back pain still affects nearly one in 10 men and one in five women.

And with a range of symptoms, pain levels, and causes, it’s not always clear when to see a doctor.  

Most cases of upper back pain can be managed at home with over-the-counter pain medication, heat or ice, exercise, and improvement of posture. However, certain symptoms in conjunction with upper back pain may indicate a serious medical issue that requires immediate attention from a healthcare professional.  

In this article, I’ll detail the symptoms and potential causes of upper back pain. Then I’ll break down the potential signs that upper back pain could be something serious and when to see a doctor. 

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Symptoms of Upper Back Pain

Common symptoms associated with upper back pain include:

• Stiffness in the back
• Aching or burning between the shoulder blades
• Pain in the upper back when breathing deeply
• Chest pain or tightness 
• Neck pain
• Indigestion 

What Causes Upper Back Pain? 

Although it can be difficult to determine the exact cause of upper back pain, common possible causes include:

• Muscle strain, sprain, or overuse: Repetitive movements, such as those from physical labor, can lead to muscle and ligament injuries. Improper lifting technique can also result in upper back pain.

• Poor posture: Slouching in a chair, hunching over a phone, or standing with the pelvis tucked under or out can all lead to upper back pain.

• Disc or nerve damage: Discs are the soft “shock absorbers” between vertebrae. If ruptured or herniated, the discs bulge, putting pressure on the spinal nerves and triggering pain that often radiates.

• Fractured vertebrae: Accidents can cause bones in the spine to break, impairing movement.

• Osteoarthritis: Though more common in the neck and lower back, this “wear and tear” type of arthritis can happen in the upper back as well. Osteoarthritis occurs when cartilage breaks down.

• Osteoporosis: Weak, brittle bones are more susceptible to fractures.

Other conditions and lifestyle factors that can contribute to upper back pain include: 

• Smoking
• Lack of physical activity
• Excess body weight
• Depression and anxiety 
• Fibromyalgia 
• Paget’s disease 

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Most upper back pain typically resolves in a few weeks with treatment at home, including stretching, taking pain relievers, applying heat or ice, or moderating certain activities that may cause back strain.

Upper back pain can even get better on its own. 

However, a serious injury to the upper back can damage the spinal cord and cause paralysis in the body below the injury.

Additionally, upper back pain may be a warning sign of a severe medical condition.

If you experience any of the following symptoms with upper back pain, talk to a healthcare provider:  

• Pain, tingling, or numbness in the arms and legs: If back pain back pain radiates from your back to your leg, this could be a sign of sciatica. These symptoms in the arms and legs could also be a sign of a herniated disc. 

• Fever without flu-like symptoms: Upper back pain associated with shortness of breath and fever could indicate a spinal infection. 

• Unexplained weight loss: If you’re losing weight without changes to your diet or lifestyle while experiencing upper back pain, it could be the result of a tumor or infection. 

• A slowing in the reaction time of arms and legs: When associated with upper back pain, a tingling or delayed reaction time of the arms and legs could be signs of cervical spondylotic myelopathy (CSM). CSM is the compression of the spinal cord. When the spinal cord is pinched, this can delay messages that the brain sends to the arms and legs to cause them to react and move. CSM is a degenerative process that can happen as we age. On average, people who have it are in their 50s or 60s.  

• Shortness of breath and chest pain: Experiencing these symptoms along with upper back pain could be signs of a heart attack. Shortness of breath and chest pain could also signify a rib injury or a problem in the lungs. 

When to See a Doctor 

If you have any concerns about upper back pain, or if you have back pain from a fall, injury, or accident, consult a doctor.

Also seek medical attention if you have any of the following symptoms in conjunction with upper back pain:

• Weakness or numbness in one or both legs
• Fever without flu-like aches
• Pain that wakes you up for more than three nights of sleep
• Back pain that persists after 4-6 weeks 
• Severe back pain that does not go away after a few days of treatment (such as ice, pain relievers, and rest)
• Pain that shoots down one leg below the knee 
• Chronic upper back pain lasting longer than six weeks that prevents you from doing daily activities 
• Numbness in the upper inner thigh, groin, buttok, or gential areas

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Frequently Asked Questions

How do you know when upper back pain is serious?

If you experience acute upper back pain from a fall, car accident, or other injury, seek medical attention immediately. Another indicator that upper back pain is serious is if you’re experiencing additional symptoms, some of which include fever (without flu-like aches), ongoing back pain, pain that wakes you up from sleep for more than three consecutive nights, weakness or numbness in the legs, back pain that lasts longer than 4-6 weeks, and radiating back pain.

When should I worry about upper back pain between shoulder blades?

Call your doctor immediately if you are experiencing severe upper back pain between the shoulder blades, as it may be signs of a serious medical condition, such as lung disease, heart disease, blood vessel disease, or gallstones.

What organs can cause upper back pain?

Organs that can cause upper back pain include the gallbladder, kidneys, and pancreas. The gallbladder can cause upper back pain between shoulder blades if gallstones, an accumulation of hard pieces of digestive fluids, have formed. Kidney problems such as kidney stones can also cause upper back pain. Additionally, a symptom of pancreatic cancer is a dull pain that occasionally occurs in the upper back.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions,
and medical associations. We avoid using tertiary references.

• Back Pain. (2020).
  https://www.mayoclinic.org/symptoms/back-pain/basics/causes/sym-20050878

• Back Pain. (n.d.).
  https://orthop.washington.edu/patient-care/articles/arthritis/back-pain.html

• Back Injuries. (n.d.).
  https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-injuries.html

• Heart Disease. (2021).
  https://www.cdc.gov/heartdisease/about.htm

• Pancreatic Cancer Symptoms. (n.d.).
  https://www.hopkinsmedicine.org/health/conditions-and-diseases/pancreatic-cancer/pancreatic-cancer-symptoms

• Prevalence of Thoracic Spine Pain in a Surveillance Network. (2014).
  https://academic.oup.com/occmed/article/65/2/122/1488588

• Upper and Middle Back Pain. (2020).
  https://www.uofmhealth.org/health-library/aba5320

• Upper Back or Neck Pain? Maybe Your Spinal Cord Is Being Compressed. (2015).
  https://healthcare.utah.edu/the-scope/shows.php?shows=0_8fnrmpdy

Upper back pain

Upper back pain is an extremely common symptom. It occurs in a variety of diseases, and therefore the key to its successful treatment is accurate diagnosis. A thorough examination usually reveals the cause of the pain.

Causes of pain in the upper back

Pain in the upper back usually accompanies various diseases of the internal organs. Respiratory system diseases:

• pleurisy with a sensation of cutting pain in the left or right side of the chest associated with breathing;

• spontaneous pneumothorax with sudden acute chest pain radiating to the scapula. Characterized by a decrease in the excursion of the chest on the side of the lesion, the absence of noise during auscultation;

• pneumonia with intense or moderate pain in the left or right side of the chest or shoulder blade. The pain is aggravated by deep breathing and coughing, fever, coughing, wheezing in the lungs during auscultation;

• lung cancer or bronchi. The nature and intensity of pains depend on its localization and prevalence; if the apex of the lung is affected, Pencost syndrome develops, in which pain is noted in the shoulder, shoulder blade, medial surface of the arm, when the pleura grows, there is pain in the chest on the side of the lesion, significantly aggravated by breathing, coughing , movements of the trunk, in case of involvement of the intercostal nerve, the pain is girdle.

Diseases of the digestive system sometimes also cause pain in the upper back. Pay special attention to the localization of pain on the right or left. Pain in the upper back on the right may indicate acute cholecystitis. Pain lasts from several hours to several days, usually localized in the right precostal space and epigastrium. Possible irradiation to the right half of the chest, right shoulder, scapula, shoulder girdle, as well as to the region of the heart, associated symptoms:

• nausea;

• vomiting;

• fever;

• jaundice of the skin;

• pain on palpation in the right hypochondrium;

• tension of the abdominal muscles.

Left upper back pain often indicates acute pancreatitis with sudden intense pain in the epigastric region of a girdle character with irradiation to the left lower chest, shoulder blade, shoulder girdle, heart area; pronounced spasm of the abdominal muscles;

Diseases of the urinary system can cause pain in the upper back. Also symptoms similar to are observed in:

Sudden lower back pain of unknown origin in a patient who received anticoagulant therapy. You should also pay attention to diseases such as:

• spinal cord lesions;

• damage to the peripheral nervous system;

• pain in the upper back, left/right.

Pain, often shooting, has the features of a projection, that is, its pattern is limited to the limits of the skin representation of the root or nerve, often has a distal distribution. For pain, it is best to seek advice from traumatologist or chiropractor . Your family doctor will also be able to conduct an examination and find out the diagnosis.

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Back pain is a common symptom of a wide variety of pathologies. To make an accurate diagnosis, even an experienced specialist needs to take an anamnesis and the results of instrumental diagnostics. Similarly, with exact localization – when the back hurts in the back of the lungs – the symptoms may indicate a different pathology. It is not always possible to immediately assert that the causes are associated with disorders of the bronchopulmonary system. It can give in the back with problems with the stomach, heart, kidneys, etc.

CMRT specialist tells

Kuchenkov A.V.

Orthopedist • Traumatologist • Surgeon • Phlebologist • Sports doctor • 24 years of experience

Publication date: September 23, 2021

Verification date: January 30, 2023

All facts have been verified by a doctor.

Contents of the article

Causes of pain in the lung area from the back

Variation of pain depending on the pathology

First aid for pain in the lung area from the back

Which doctor to contact

Mamaeva Lidia Semyonovna

Neurologist • Reflexologist • Physiotherapist • Hirudotherapist
experience 48 years

Konovalova Galina Nikolaevna

Neurologist
experience 44 years

Linkorov Yury Anatolyevich

Neurologist
experience 42 years

Kuznetsova Elena Nikolaevna

Neurologist
experience 32 years

Yan Anzhela Alexandrovna

Neurologist • Reflexologist
experience 23 years

Kareva Tatyana Nikolaevna

Neurologist
experience 22 years

Ismailova Elvira Tagirovna

Neurologist
experience 20 years

Agumava Nino Mazharaevna

Neurologist
experience 19 years

Lysikova Tatyana Gennadievna

Neurologist • Physiotherapist
experience 19 years

Bachina Natalya Iosifovna

Neurologist
experience 19 years

Repryntseva Svetlana Nikolaevna

Neurologist
experience 18 years

Lisin Valery Igorevich

Neurologist
experience 15 years

Shishkin Alexander Vyacheslavovich

Neurologist • Chiropractor
experience 13 years

Dorofeeva Maria Sergeevna

Neurologist
experience 11 years

Filippenko Anton Olegovich

Neurologist • Reflexologist
experience 11 years

Amagova Tamila Magomedovna

Neurologist
experience 9 years

Miropolsky Ilya Andreevich

Neurologist
experience 9 years

Suleymanov Kurban Abbas-Ogly

Neurologist
experience 9 years

Satieva Marina Garunovna

Neurologist
experience 7 years

Diagnostic methods

How to treat back pain in the lungs

Rehabilitation

Rehabilitation deserves special attention. Without it, therapeutic measures will be incomplete, the likelihood of relapse increases.

An individual recovery program in the rehabilitation center “Laboratory of Movement” is compiled by experienced specialists, based on indications, examination results and the conclusion of the attending physician.

The center presents modern equipment and simulators aimed at complex or point rehabilitation.

Consequences

Prevention

Other related articles:

Rehabilitation after a spinal injury

The most important step in the conservative or surgical correction of traumatic injuries of the central axis of the musculoskeletal system is rehabilitation. Recovery after spinal injuries has several goals, the main of which are minimizing the risk of post-traumatic complications, returning to an active and fulfilling life.

Violations of posture

Among the numerous musculoskeletal problems, the most common and topical is spinal deformity. Violation of posture, due to various congenital and acquired causes, is formed at any age and tends to progress. However, with a timely appeal to an orthopedist, any deviation from the natural position can be adequately corrected. The main thing is not to miss the moment while the pathological changes are reversible.

Osteochondrosis

Vertebrogenic pathologies caused by degenerative-dystrophic changes in the intervertebral discs and adjacent tissues have a common name – osteochondrosis. Pain in the cervical and lumbar regions is most often associated with osteochondrosis, one of the most common diseases of the musculoskeletal system.

Displacement of the spine

Displacement of the spine – a violation of the location of one vertebra relative to another with a deviation forward or backward relative to the axis of the spinal column. Depending on the location, it manifests itself as a sharp pain, numbness of the limbs, impaired mobility, and neurological disorders. The pathological condition is more common in middle-aged and elderly people. Timely diagnosis and treatment minimize the occurrence of severe consequences in some cases leading to disability.

Degenerative changes of the spine

Degenerative-dystrophic diseases of the spine are manifested by structural and functional changes in the system of elements of the vertebral motor segments. Intervertebral discs, end plates, facet joints, and, in advanced stages, the spinal canal and spinal cord may be involved in the process. Symptoms are variable, depending on the location, stage of the disease. Diagnosis involves CT, MRI. The treatment is conservative, in difficult cases with the destruction of the vertebrae, the formation of hernias – surgical.

Injury of the spine

Injury of the spine – traumatization of any or all of its constituent structures: bones, ligaments, spinal cord. Pathology accounts for about 17% of all injuries of the musculoskeletal system, about 2-3% of cases are complicated.