Upper back pain

Expert review by:

Jasmine Ward, Musculoskeletal Therapist at Bupa

Content review by:

Rachael Mayfield-Blake, Freelance Health Editor

Page last reviewed: November 2023
Next review date: November 2026

Key points

You may feel upper back pain between your neck and waist, including the area between your shoulder blades. Upper back pain is also known as thoracic back pain.
Common causes of upper back pain include poor posture, injuries, strains, and health conditions such as arthritis.
You can ease upper back pain by improving your posture, taking over-the-counter painkillers, and stretching. Gentle exercise may also help.

What is upper back pain?

Upper back pain (thoracic back pain) is pain anywhere between your neck and your waist, including between your shoulder blades. Although less is known about upper back pain compared with lower back pain, it’s still common.

Treatment of upper back pain

If you have upper back pain, it’s likely to get better by itself without treatment. If it’s not caused by anything serious, it may get better within a few weeks.

If the pain is caused by a particular condition, your treatment will vary depending on the underlying problem that’s causing the pain.

Treatments may include:

medicines
physiotherapy
injections
manual therapies, such as physiotherapy, osteopathy and chiropractic
surgery

How do I relieve upper back pain?

Try some self-care measures to get upper back pain relief. For example, you can:

improve your posture
take over-the-counter painkillers, such as ibuprofen or paracetamol – always read the patient information leaflet first
do some stretches
do some exercise – keep moving and do some gentle exercise within your limits of pain and discomfort

Looking for physiotherapy?

You can access a range of treatments on a pay as you go basis, including physiotherapy.

To book or to make an enquiry, call us on 0370 218 6528^∧

Find out more about physiotherapy

Causes of upper back pain

There are lots of potential causes of upper back pain.

Upper back pain is often caused by having poor posture for a long time. Good posture means being able to maintain, but not increase, the natural curves of your spine. Keep your head level – try not to tilt it. Your ears, shoulders, hips, and ankles should all be in line.

Other causes of upper back pain include:

an accident or sudden injury, such as whiplash or a sports injury
straining a muscle or ligament in your back
weak muscles in your back, from not doing much exercise, for example
sitting at a computer for long periods of time
carrying a back pack
repetitive movements causing overuse injury

Upper back pain can also be caused by some health conditions, such as:

osteoporosis – when your bones gradually become weaker and more likely to break
osteoarthritis – a condition that causes painful, stiff joints
spinal stenosis – the passage that carries your spinal cord through your vertebrae (the spinal canal) narrows and presses on the nerve
ankylosing spondylitis
disc herniation – one of the shock-absorbing discs between the bones in your spine (vertebrae) can bulge to one side
psychological stress – this can affect how much pain you feel

Symptoms of upper back pain

Symptoms of upper back pain can vary and depend on what’s causing the pain. The pain can be mild or more severe. You might have sharp pain in one particular spot, or a general achiness that comes and goes. Although pain can be useful to warn us there’s something wrong, it can also be a sign that you're overdoing it and need to take care of yourself.

If your back pain significantly affects your daily activities or stops you from getting a good night’s sleep, see a physiotherapist or GP.

Can upper back pain be a sign of something else?

You might have another condition that causes referred pain in your upper back. This is when a problem elsewhere causes pain in your upper back. For example, if you have a condition that affects your:

lungs
oesophagus (food pipe)
stomach
pancreas
liver
gallbladder

Diagnosis of upper back pain

Your physio or GP will ask about your symptoms and examine you. They may 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. For example, if:

your symptoms haven’t eased despite changing position or resting
you’ve had pain for more than two weeks despite having treatment
you have pain that you don’t think has been caused by a sprain or strain in your upper back
you’re very stiff in the morning
you have pain all the time and it’s getting worse

Your physio or GP will ask questions to understand what could be causing your upper back pain. They will also consider whether you:

have had a recent injury to your back, such as a car accident or a fall
have cancer, or a weakened immune system
have symptoms of an infection, such as a fever, unexplained weight loss and chills
are younger than 20, or older than 50
have diabetes

Depending on your symptoms, examination and medical history, your GP or physio may refer you for further tests. These might include:

If you have another condition that affects your lungs, oesophagus (food pipe), stomach, pancreas, liver or gall bladder, you might have referred pain. This is when a problem elsewhere causes pain in your upper back.

blood tests
X-rays
MRI scans
bone density scan (DEXA) - this measures how strong your bones are

When should I be concerned about upper back pain?

Seek urgent medical attention if you experience:

issues with balance or walking
difficulties with bladder or bowel control
pins-and-needles tingling, weakness, or numbness in your upper or lower back, or down your legs
difficulty breathing, fever, chills, or severe headaches

Prevention of upper back pain

The following tips may help to prevent you from developing upper back pain.

Properly support your back when you’re sitting.
If you work at a desk, make sure your equipment is set up correctly.
If you wake up with back pain, a more supportive mattress may help.
Take regular breaks from sitting for long periods of time and from doing repetitive tasks.
Have good posture and when you lift objects, do this safely and correctly.
Exercise regularly.
Stop doing any activity that you know causes your back pain.
Stop smoking – it can damage the discs between your vertebrae that act as shock absorbers.
If you’re overweight, losing weight may help to reduce the risk of back pain.
Change activities that cause you pain so you can still enjoy them – slow down, do less, get help, for example.

Looking for fast access to quality care?

If you’re suffering from a muscle, bone or joint injury, as long as your symptoms are covered under your policy you can call us for advice and we can often authorise a consultation without the need for a GP referral.

To get a quote or to make an enquiry, call us on 0808 273 6216^∧

Find out about Bupa Direct Access

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