What Is Upper Back Pain
Upper back pain occurs anywhere from the base of your neck to the bottom of your rib cage. Your upper and middle back is called the thoracic spine. Your thoracic spine has 12 small bones called vertebrae. Your vertebrae form your backbone.
Each of the vertebrae on your thoracic spine is connected to a pair of ribs. Your ribs wrap around your body to a long, flat bone down the center of your chest called the sternum. This forms your rib cage.
Your upper back also has disks that separate each vertebrae. These disks absorb shock as you move. There are also many muscles and ligaments in your upper back that hold your spine together. Upper back pain may be caused by many different medical issues or injuries to the bones, disks, muscles and ligaments in your upper back.
Upper back pain is not as common as neck pain or low back pain. This is because the bones in the upper area of your back don’t move or flex as much as the bones in your neck and lower back. The bones in your upper back work with the ribs to keep the back stable. They work together to help protect vital organs in your body including your heart and lungs.
Why Does My Upper Back Hurt When I Go For A Walk
Upper back pain is usually caused by soft tissue injuries, such as sprains or strains, or muscle tension caused by poor posture or looking downward for long periods. Poor posture and text neck can combine to wreck your upper back. Common behaviors and activities that can cause upper back pain include: Poor posture.
Upper And Middle Back Pain
Your upper and middle back, also known as the thoracic spine, is made up of 12 vertebrae that attach to your rib cage, discs that sit between each vertebrae, and various ligaments and muscles holding your spine in place. Upper and middle back pain can be felt anywhere from the bottom of your ribs to the base of your neck. A pinched nerve in your thoracic spine can also cause referred pain in your stomach, chest, legs, and arms.
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What Causes Upper And Middle Back Pain
Sprains, Strains, and Other Injuries
The complex thoracic spine carries a lot of the body’s stress and is involved in most upper body movements. Many cases of upper and middle back pain are caused by external forces that can stress the muscles, ligaments, and discs, such as:
- Muscle stress and strain. Discomfort may result from poor posture, not lifting correctly, or muscle overuse.
- Accidents. An injury sustained during a sports or car accident can cause upper and middle back pain.
Spine conditions affecting the upper and middle back
Sometimes certain spine conditions can cause thoracic back pain. Treating the condition can lead to relief of the discomfort. Examples of these conditions include:
Treatment For Mild To Moderate Pain

In most cases, people with mild to moderate upper and middle back pain can manage their symptoms with:
- Over-the-counter pain medicines. These include acetaminophen and NSAIDs , to reduce pain.
- Topical pain medicines. These are medicines that you put on your skin.
- Nonsteroidal anti-inflammatory drugs . This is a cream that you can rub over the sore area and may help relieve pain.
- Capsaicin cream. This may help relieve pain.footnote 1 It’s a substance found in cayenne peppers. Capsaicin cream is applied directly to the skin over the painful area.
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Common Upper And Middle Back Pain Symptoms
Upper and middle back pain can affect everyday movement and make routine tasks such as getting dressed or playing sports extremely difficult. This pain can start suddenly or develop gradually. Upper and middle back pain symptoms may include:
- Sharp pain, often described as a burning sensation or knife-like pain. This sharp pain can be limited to one spot or may become radiating pain that travels along a nerve to other areas.
- General achiness may begin in one region and spread to a nearby area.
- Stiffness resulting from reduced mobility in your back may be caused by pain or achiness.
- Tingling , numbness, or weakness may feel like a nerve is being compressed.
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.
References
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Causes Of Upper And Middle Back Pain
There are a number of things you may be doing at work or at home that can cause you to experience pain in the upper and middle back, such as:
Poor posture. If you spend countless hours at a computer or you are an avid texter, chances are the muscles in your upper back area are working overtime. The head alone weighs about 10 pounds and the muscles are busy supporting it as you stare at the screen hour after hour. You probably dont even realize that your shoulders, upper back, and neck are slouching forward which creates the aching pain. Good posture and getting up and moving around at different times throughout the day can go a long way in reducing the strain on these muscles.
Stress. From work to home, there are many situations that can cause you to be stressed. When you experience stress, your neck and shoulder muscles tense up, and can cause constant pain over time.
Strenuous exercise. A great workout, one that pushes you to feel the burn can be welcome. However, strenuous exercise can cause strain in the muscles in the neck and shoulder areas. Lifting heavy objects repeatedly in a work environment can also lead to long-term pain in the upper and middle back area.
Vertebrae injury. The most common injury to the vertebrae is often due to an auto accident. A fracture of a vertebra or misalignment can produce excessive pain that limits your mobility altogether.
Herniated Disc. Compression of discs in the spine can lead to constant pain, likely due to aging.
Treatment Of Upper Back Pain
If you have upper back pain, its likely to get better by itself without treatment. If its not caused by anything serious, it will probably get better within a few weeks.
You can try some self-care measures such as improving your posture or putting an ice pack or heat pack on the area that hurts. Make sure you wrap this in a towel and dont apply it directly to your skin. You can also take over-the-counter painkillers such as ibuprofen or paracetamol as pain relief for upper back pain. Ask your pharmacist for advice.
If the pain is caused by a particular condition, your treatment will vary depending on the underlying problem thats causing the pain.
Treatments may include medicines, physiotherapy, injections and manual therapies.
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Hope For Those Suffering From Upper Middle Back Pain
If you are among the millions who suffer from back pain, then you will be happy to know that upper cervical chiropractic care can help more than just those with scoliosis. This specialty in the chiropractic field focuses on the adjustment of the C1 and C2, the top two bones in the spine that are located at the base of the skull. Misalignments in this area can have far-reaching effects on the body and can particularly affect the rest of the spine since the bones and soft tissue have a built-in tendency to shift to keep the head level.
Upper cervical chiropractors take precise measurements of the C1 and C2 using modern diagnostic imaging techniques. This allows us to provide gentle adjustments that are tailored to each patients needs. If you have experienced general chiropractic, but not upper cervical, you are in for a surprise. Our adjustments are low-force and require little to no pressure. Some practitioners even use an adjusting instrument instead of their hands.
The results, however, speak for themselves. And unlike painkillers which come along with side effects and provide little long-term benefit, upper cervical chiropractic care is safe and effective on a long-term basis because it gets to the root of many back problems. To learn more, contact a practitioner in your local area to schedule a no-obligation consultation.
to schedule a consultation today.
Potential Signs It Could Be Something Serious
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 youre losing weight without changes to your diet or lifestyle while experiencing upper back pain, it could be the result of a tumor or infection.
- 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.
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Our Thoracic Spine Specialists
Och Spine is backed by world-class Columbia University and Weill Cornell Medicine doctors who treat upper and middle back pain in patients both throughout our region and around the world.
Our multidisciplinary team of thoracic pain specialistsincluding top orthopedic and neurosurgical spine surgeons, rehabilitation medicine physicians, nurses, and physical therapistsare committed to finding solutions to relieve upper and middle back pain.
How Do I Know If I Have This

Back pain is experienced by people in the population and having mid-back pain does not mean you have pancreatic cancer. However, if you are experiencing mid back pain that is not normal for you, there is no harm in checking with your GP especially if you are experiencing any of the other symptoms described here.
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Why Does My Upper Back Hurt When Lying Down
Stride Strong Physical TherapySome possible causes include
- Lying down puts more pressure on the part of the back that is affected, such as the vertebrae, spinal discs, spinal nerves, muscles, ligaments, or connective tissue. Holland says this can happen if you have abnormal rounding of the upper back , which makes lying on your back uncomfortable.
- Your pillow or mattress arent a good fit. It could hint that your pillow is too high or too low or unsupportive when you are sleeping, says Holland. Your mattress may also be too hard or not provide enough support.
- A lack of movement while lying down for a long time may cause muscles to become more stiff or tight.
- If you toss and turn a lot while sleeping, this can put additional strain on the back muscles or spine.
When To See A Doctor
If youâre like most people with upper and middle back pain, youâll be able to manage your symptoms at home. Over-the-counter pain relievers, heat, or ice may be enough to ease your condition.
You should call your doctor, though, if your pain becomes too intense or starts to keep you away from your daily activities.
Certain symptoms require fast attention. They include:
- Losing control of your bowels or bladder.
- Fever along with pain.
- Pain that starts after a fall, an accident, or a sports injury.
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What Are Treatment Options
Diagnosing your upper and middle back pain is the first step in determining the treatment plan. Our providers will complete a physical exam, take a medical history, and may also need to do an x-ray, CT, or MRI.
For some, upper and middle back treatment may involve a combination of over-the-counter pain medication, hot and cold packs, rest and minimal activity for a short period of time. Posture exercises may also be suggested.
If the back pain is found to be more severe, we may consider treatments that include prescription medications, trigger point injections, or kyphoplasty.
The bottom line: upper and middle back pain is treatable and we can help. If you are suffering from upper and middle back pain, call the pain medicine experts at Innovative Pain & Spine Specialists in Lincoln and Omaha, Nebraska at and schedule an appointment today.
How To Treat Middle Back Pain
If you have a problem with vertebrae in your spine you might need to rest for a short time , and then gradually become more active.
It may help to apply heat to the area. Voltarol non-medicated Heat Patch is designed to target back and muscle pain, providing up to 8 hours of localised pain-relieving heat. The thin, self-adhesive, odourless patch provides effective pain relief and muscle relaxation in a non-medicated, tablet-free format.
Pain-relieving medicines can help you get up and moving. To decide which medicine is best for you, it may help to learn a bit about pain, and what happens in your body in the article: Understanding the difference between acute and chronic pain.
Voltarol Back & Muscle Pain Relief 1.16% Gel is a topical medicine that relieves pain, reduces inflammation and helps speed up recovery with its triple effect action.¹ ¹¹ It brings targeted, local relief for pain and swelling .¹² ¹³ The active ingredient in Voltarol Back & Muscle Pain Relief 1.16% Gel is a NSAID called diclofenac. Diclofenac works to inhibit prostaglandins synthesis .¹ By reducing their amounts, diclofenac helps to relieve pain and reduce inflammation.¹
Ask a pharmacist or your GP if you would like advice about what would be the best treatment for you.
Once you feel more comfortable, its a good idea to see a physiotherapist to do an exercise programme to strengthen the muscles in your back and improve your posture. ¹
References
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How Can I Relieve Upper Back Pain At Home
Use an ice pack and an over-the-counter pain reliever such as acetaminophen, aspirin, ibuprofen, or naproxen. After the inflammation calms down, a heating pad or pack can help soothe muscles and connective tissue. If you have chronic back pain, sleep on a medium-firm mattress. Pay attention to your posture.
Exercises For Upper And Middle Back Pain
Pain in the upper and/or middle back can be quite limiting and interfere with daily activities. To help alleviate this pain, consider stretching and strengthening the muscles that support your thoracic spine . Here are 5 common exercises to try.
See Early Treatments for Upper Back Pain
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What Is Middle Back Pain
Middle back pain is any type of pain or discomfort in the area between your upper and lower back. Healthcare professionals refer to this area as the lower thoracic area or lower thoracic spine. The upper thoracic area or upper thoracic spine makes up part of the upper back. The lumbar spine makes up part of the lower back.
The middle back consists of the spine , spinal cord, nerves, discs, muscles, blood vessels, ligaments, and tendons. Any of the structures in the spine or back area can become irritated or inflamed in response to a variety of mild to serious conditions. Middle back pain causes include sports injuries, poor posture, arthritis, muscle strain, and car accident injuries. Middle back pain is not as common as lower back pain because the thoracic spine does not move as much as the spine in the lower back and neck.
Pain in the middle of the back may be either short lived or chronic, which is defined as lasting more than three months. Middle back pain may be described as a dull, annoying ache or a sharp, acute pain. The pain can radiate, or spread, to other areas of your body. The converse is also true pain that is caused by a problem somewhere else in your body can radiate to your middle back.
In some cases, acute back pain can resolve with basic self-care measures within a few weeks, but it can also persist and lead to more serious problems over time.