Upper Back Pain: 8 Common Causes & When to See a Doctor

Upper back pain can be caused by muscle tension, blows or injuries in the neck area, a herniated disc or cervical osteoarthritis. It is associated with symptoms such as neck pain or stiffness.

Upper back pain, or cervical spine pain, can also lead to pain that radiates to the shoulders or arms, a tingling sensation, weakness or loss of strength in the arms, or a headache in the back of the neck.

Although most of the time, upper back pain is temporary, it is important to see a family doctor or orthopedic surgeon if pain lasts for more than 3 days to improve or if it causes other symptoms. The doctor will assess your pain to identify and initiate treatment as necessary.

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What causes upper back pain?

Some of the most common causes of upper back pain are:

1. Muscle tension

Muscle tension, or torticollis, is the most common cause of upper back pain. It is normally caused by everyday activities or behaviors like  poor posture, sitting for prolonged periods of time, sleeping in the wrong position or contracting neck muscles during physical exercise.

Muscle tension can also occur during periods of high stress, as tension often causes contractures to appear in the cervical region.

What to do: an easy way to relieve discomfort is to stretch your neck 2 to 3 times a day for at least 5 minutes. Applying warm compresses to the area for 10 to 15 minutes may also help. Check-out some upper back and neck stretches that you can perform to help manage pain.

2. Blows or injuries

Upper back pain can be caused by injuries, from a car accident or contact sports, for example.

Because is an easily exposed and sensitive area, the neck can undergo various types of injuries, which end up causing pain.

What to do: normally, pain from a direct blow is relatively mild and resolve within a few days by applying hot compresses for 15 minutes a day. However, if the pain is very intense or if other symptoms appear, such as difficulty moving the neck or tingling in the arms, it is important to seek medical attention.

3. Cervical osteoarthritis

Cervical osteoarthritis arthrosis, also known as cervical arthrosis or spondyloarthrosis, occurs due to wear and tear of the cartilage between the vertebrae in the cervical spine. This results in inflammation and symptoms such as intense neck pain, difficulty moving the neck or a sensation of tingling or numbness in the face, arms or neck.

In addition to neck pain, other symptoms may also appear, such as headache and small clicking sounds when moving the neck.

What to do: Physiotherapy to typically advised to relieve discomfort caused by cervical osteoarthritis, however, the orthopedist may also recommend prescribe medications to reduce inflammation and relieve pain.

4. Herniated disc

Cervical disc herniation happens when the discs between the vertebrae of the spine, which act as shock absorbers, are pressed and change shape. This can put pressure on nearby nerve roots, causing symptoms such as constant pain, tingling or numbness in the arms.

Cervical disc herniation is more common after the age of 40, but it can appear earlier, especially in people who have poor posture or who work in less comfortable positions, such as painters, bakers or dentists.

What to do: Treatment for a herniated disc should be guided by an orthopedic surgeon who may prescribe physiotherapy or analgesic and anti-inflammatory medications. This approach can help relieve pain and reduce inflammation. In more serious cases, however, surgery may be necessary.

5. Osteophytosis

Osteophytosis occurs when a part of the vertebra grows larger than normal, causing a protrusion of bone that resembles a parrot's beak. Although this protrusion does not cause pain, it can end up pressing on the nerves in the spine, which leads to symptoms such as pain, tingling and even loss of strength.

What to do: Osteophytosis should be diagnosed by an orthopedic surgeon and treatment usually involves physiotherapy and anti-inflammatories.

6. Degenerative disc disease

Degenerative disc disease is the progressive wear and tear of the intervertebral discs in the cervical spine. This condition is usually caused by normal aging and is common in people over 40 years of age.

Generally, this wear does not cause pain, however, in some cases, pain in the neck, tingling sensation or weakness in the arms may appear. If left untreated, it can quickly progress into arthritis.

What to do: Treatment for degenerative disc disease should be guided by an orthopedic surgeon, who may prescribe anti-inflammatories or analgesics to relieve symptoms, physiotherapy or surgery, in more serious cases.

7. Cervical spondylosis

Cervical spondylosis is wear and tear on the vertebrae of the cervical spine and intervertebral discs. This condition leads to compression of the nerves, causing symptoms such as upper back pain or shoulder pain. This pain can radiate to the arms, and cause neck stiffness or a headache in the back of the neck.

This condition can arise due to natural aging of the body, which is why it is more common in the elderly, however, it can appear in anyone who is overweight or has poor posture.

What to do: Treatment should be carried out by an orthopedic surgeon, who may prescribe anti-inflammatories or analgesics to relieve symptoms, as well a cervical collar or surgery.

8.  Hyperlordosis

Hyperlordosis is characterized by an accentuated, inward curvature of the spine, which can occur in the cervical region and lead to upper back pain.

This spinal problem can be caused by poor posture, a sedentary lifestyle, obesity or progressive muscle weakening, called muscular dystrophy.

What to do: Treatment of hyperlordosis is guided by an orthopedist, who may recommend regular exercise, physiotherapy or global postural recovery or “RPG".

When to see a doctor

You are advised to consult a doctor if your experience constant upper back pain, so that the doctor can assess and identify the underlying cause of it.

You should also see a doctor if you upper back pain is accompanied by symptoms such as:

  • Severe neck pain
  • Pain that radiates to the shoulder or arms
  • Difficulty moving the neck or arms
  • Persistent pain or pain that worsens over time
  • Fever or chills
  • Accidents that may have injured the spine
  • Muscle weakness
  • Feeling of sand in the neck joints

These symptoms generally indicate that the pain is not just a muscle contracture and, therefore, should be evaluated by an orthopedic surgeon.

During the consultation, in addition to evaluating the symptoms, the doctor may order image tests, such as X-ray or MRI, to better evaluate the cause.