The 9 main causes of upper back pain

Upper back pain is usually the result of poor posture, muscle overuse, or injury. Treatment may include home remedies, such as rest and gentle exercise, or possibly seeing a physical therapist.

The upper back is the area between the base of the neck and the bottom of the rib cage. The upper back is made up of 12 bones, which doctors call the thoracic spine. The first upper back bone begins at the base of the neck, and the 12th bone ends just below the rib cage. Upper back pain can appear anywhere between these bones. Most people describe upper back pain as a burning or pulling sensation in one spot, which may be due to injury or tension.

Common causes of upper back pain

Although less common than lower back pain or neck pain, a study published in the journal Occupational Medicine indicates that one in ten men and one in five women may suffer from upper back pain. Doctors call upper back pain “thoracic spine pain” or TSP. Common causes are:

1. Muscle deconditioning and poor posture

Infrequent or incorrect use of muscles can cause back pain. People can condition their muscles over time to be stronger or longer lasting through exercise and strength training. The reverse is also true. Humans can decondition their muscles over time by not using them properly.

For some muscles, especially those in the back, deconditioning is as simple as sitting too long at a desk with poor posture. A person can do it at work.
Slumping in a chair over a desk can lead to loss of muscle strength. Over time, weakened muscles can lead to pain in the affected area due to tension or irritation. When a person slumps, the pressure of gravity and the body itself acts 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 begins with posture correction while sitting and regular breaks at the desk to move and stretch. Exercises can also improve back strength, and using a standing desk can also be helpful.

Muscle conditioning, however, takes patience, and anyone with chronic upper back pain due to muscle weakness is well advised to consult a physical therapist, osteopath or chiropractor to find an exercise program that suits their needs. specific.

2. Muscle overwork

Overuse of back muscles is another common cause of upper back pain. This usually happens due to the repetition of the same movements over time. This can be a cause of:

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– muscle strain
– twitching
– irritation

The classic example is that of a tennis player, who performs a similar motion every time he throws, which can often put a strain on his shoulder. Other repetitive activities can cause similar pain. A person who has to perform the same movement all day, or who lifts objects above their head throughout the day, for example, may begin to experience muscle irritation, tightness, or tension. If she ignores these signs, it can turn into chronic pain.

Treatment for muscle overuse typically begins with resting the affected area, along with applying heat or ice to promote blood flow to muscle tissue. It may help to find ways to avoid the repeated movement when possible or to take breaks between activities. A physical therapist can recommend exercises to promote flexibility and strength in the area.

3. Traumatic injury

A traumatic injury can also lead to back pain. This can be the result of situations such as:

– car accidents
– slip and fall
– work accident
– incorrect lifting
– excessive physical exertion

The injury is sometimes obvious, and the pain appears immediately after the incident. In other cases, the pain may not show up until later or the next day. Traumatic injuries can be serious, and injury-related problems, such as fractured vertebrae, put a person at risk for lasting complications, including chronic pain, nerve damage and paralysis. A doctor should examine all potential back injuries, as it is vital that they heal properly to avoid long-term pain.

4. Herniated disc

Herniated discs are more common in the lower back, but they can sometimes occur in the upper back as well. Discs are the soft, rubbery cushions located between each vertebra. A herniated disc occurs when a piece of this cushion pushes through and puts pressure on the spine. Even a little pressure can lead to significant pain in the middle of the back, along with other symptoms, including numbness or weakness in the arms or legs. Most people do not need surgery for a herniated disc and will recover with rest or anti-inflammatory medication.

5. Pinched nerve

A herniated disc can slip far enough to compress the nearby nerve. A pinched nerve in the middle of the back can cause:

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

When a pinched nerve originates from a herniated disc, the treatment is similar to the treatment for a herniated disc. A pinched nerve usually does not require surgery.

6. Osteoarthritis

The source of back pain is sometimes not the muscles, but a problem with the bones and joints. The cartilage that cushions and protects bones can wear down with age. The term used to refer to this phenomenon is osteoarthritis. It is the most common form of arthritis in older people.

Osteoarthritis can eventually lead to the complete disappearance of the cartilage between the bones, causing the bones to rub against each other. It can also put pressure on the nerves in the spine and cause numbness or tingling in the arms and legs. Anyone who thinks they have osteoarthritis should see a doctor for a diagnosis and a treatment plan. Treatment usually focuses on managing pain and keeping joints functioning.

7. Myofascial pain

The pain can also come from problems in the connective tissue of the back, which doctors call the fascia. Myofascial pain can appear after injury or overuse, but chronic myofascial pain can last long after the initial injury. It is still unclear why myofascial pain persists in some cases. Doctors may recommend physical therapy and myofascial release therapy to allow a person to work the fascia and relieve pain.

8. Spinal infection

In some cases, surgery may be needed to treat a spinal infection. In rare cases, an infection can cause upper back pain. A spinal epidural abscess is a collection of germs and pus that forms between the spinal cord and the bones of the spine. The abscess may grow and swell, causing pain. Early diagnosis is key, and doctors will treat a spinal abscess quickly to avoid serious complications. Antibiotics can help, and surgery may be needed to remove the abscess and reduce the risk of complications.

9. Lung cancer

Back pain can be due to lung cancer in very rare cases. A case study published in the Journal of the Advanced Practitioner in Oncology highlights such a case. The study indicates 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.

Other conditions

Specific pathologies affecting the spine or muscles can also lead to pain in the upper back. These include in particular:

– scoliosis
– fibromyalgia
– deformation of the spine
– problematic kyphosis

The treatment for each condition varies and its success is variable.

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Prevent upper back pain

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

– Take regular breaks while sitting or lying down to stretch and move different muscle groups.
– Take frequent breaks when working at a desk to stretch, so muscles stay flexible and strong.
– Take a few minutes to stretch the muscles or warm up the body before any activity.
– People who lift heavy objects should avoid twisting or lifting with their backs.
– Have a massage regularly to eliminate muscle tension.
– Work with a physical therapist or osteopath to strengthen weak muscles and relieve joints.
– Avoid carrying heavy backpacks or handbags.

Be aware of your posture at all times, walk straight and sit correctly, using back supports if necessary.


Bond, A., & Manian, FA (2016, December 1). Spinal epidural abscess: A review with special emphasis on earlier diagnosis. BioMed Research International, 2016, 1614328

Cathcart, E., McSweeney, T., Johnston, R., Young, H., & Edwards, DJ (2018, October 24). Immediate biomechanical, systemic, and interoceptive effects of myofascial release on the thoracic spine: A randomized controlled trial [Abstract]. Journal of Bodywork and Movement Therapies

Cramer, H., Mehling, WE, Saha, FJ, Dobos, G., & Lauche, R. (2018, April 6). Postural awareness and its relation to pain: Validation of an innovative instrument measuring awareness of body posture in patients with chronic pain. BMC Musculoskeletal Disorders, 19(1), 109

Doherty, LM (2012, May–June). Back pain in a patient with lung cancer. Journal of the Advanced Practitioner in Oncology, 3(3), 195–196

Herniated disc (cervical, thoracic, lumbar). (nd)

Kim, DJ, Cho, ML, Park, YH, & Yang, YA (2015, March 24). Effect of an exercise program for posture correction on musculoskeletal pain. Journal of Physical Therapy Science, 27(6), 1791–1794

* Presse Santé strives to transmit medical knowledge in a language accessible to all. In NO CASE can the information given replace medical advice. [HighProtein-Foods.com]

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