Diagnosis of upper back pain
Your doctor will ask about your symptoms and examine you. They may then be able to diagnose and explain the cause of your back pain or they may need to refer you for some tests. Upper back pain is often caused by muscle strain, but sometimes there might be a more serious cause. Red flags are certain features and symptoms that your doctor will identify that may mean your upper back pain is being caused by a more serious underlying condition.
Red flags may include:
- recent injury to your back such as a car accident or a fall
- if you’ve lifted something heavy – particularly if you have osteoporosis
- if you’ve had cancer before or you have a weakened immune system
- other symptoms such as a fever, unexplained weight loss and chills
- if you’ve recently had a bacterial infection
- if you’re younger than 20 or older than 50
Your doctor will also ask you about the pain to understand how severe it is and what could be causing it. They may ask you:
- if symptoms haven’t eased despite changes to your posture or resting
- if you’ve had pain for more than two weeks despite having treatment
- if you have pain that you don’t think has been caused by a sprain or strain in your upper back
- if you feel very stiff in the morning
- if you have pain all the time and if it’s getting worse
Your doctor may also ask if you have a feeling of weakness in your legs, or if you have bladder and bowel problems such as incontinence. This may point towards a slipped disc or injury that is pressing on the nerves in your spine, and sometimes your spinal cord.
If you have an underlying problem that is affecting your lungs, oesophagus, stomach, pancreas, liver or gall bladder, you might have referred pain. This is when a problem elsewhere is causing pain in your upper back.
Depending on your symptoms, examination and medical history, your doctor may refer you for further tests. These might include blood tests, X-rays and an MRI scan (a test that uses magnets and radio waves to produce images of the inside of your body). You might also have a DEXA scan, which measures how strong your bones are.