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Upper Back Pain

Upper back pain is a common complaint ranging from minor discomfort to sharp pain and a debilitating daily life issue. While most cases of upper back pain are due to muscular strain or long-term poor posture, it’s essential to be aware of a serious underlying cause. Some potential underlying causes of upper back pain include herniated discs, osteoarthritis, rib cage injury, spinal stenosis, and spinal epidural abscess. It is important to pay attention to red flags such as persistent pain, numbness or tingling in the arms or legs, and difficulty with bowel or bladder control, as these may indicate a more serious condition that requires medical attention, blood tests, radio waves, and physical therapy. 

In this article, we will explore when to worry about upper back pain, its potential causes, commonly affected soft tissues from sports injury, red flags to watch out for, how to differentiate between muscular and other types of upper back pain symptoms, myofascial pain syndrome and the connection between upper back pain and heart health, and what to do when your upper back pain persists.

When Should I Worry About Upper Back Pain?

Regularly experiencing upper back pain after a long day or strenuous activity is normal. However, suppose the pain becomes persistent and is accompanied by other symptoms, such as difficulty breathing or radiating pain down the arm. In that case, it may be a sign of a more serious condition that requires medical attention.

It is important to consult with a healthcare professional or a physical therapist to determine the underlying cause and appropriate treatment for your upper back pain. There are certain situations when you should be more concerned:

Persistent Pain

If your upper back pain lasts for more than a few weeks, it’s time to see a physical therapist. Chronic pain could indicate an underlying issue that requires proper diagnosis and treatment. Ignoring persistent upper back pain can lead to further complications and may hinder your daily activities. It is important to address the issue promptly to prevent it from worsening and to improve your overall quality of life. 

Severe Pain

Intense, excruciating pain that limits your ability to move or perform everyday tasks should not be ignored. Severe pain may be a sign of a serious injury or condition that requires immediate medical attention. Delaying treatment can lead to further damage and potentially long-term consequences.

Pain Radiating Down the Arm

Pain that travels down your arm, possibly accompanied by numbness or tingling, could indicate a nerve-related problem. It is important to seek medical attention if you experience pain radiating down your arm, as it may indicate a pinched nerve or a herniated disc in your neck. Ignoring this symptom could worsen the condition and potentially lead to long-term nerve damage.  

Unexplained Weight Loss

If you are experiencing upper back pain along with unexplained weight loss, it might signal a more serious underlying condition. It is recommended to consult a healthcare professional as this combination of symptoms could indicate conditions such as cancer or infection. Prompt medical evaluation can help determine the cause and provide appropriate treatment if necessary. 

What is Upper Back Pain a Symptom Of?

Upper back pain can be a symptom of various conditions, including muscle strain, poor posture, herniated discs, or osteoarthritis. Consulting a healthcare professional for an accurate diagnosis and appropriate treatment plan is important. The most common conditions include:

Muscular Strain

Poor posture, overuse, or sudden movements can strain the muscles in your upper back, leading to pain and discomfort. Muscular strain can also be caused by lifting heavy objects or participating in activities that require repetitive upper-body movements. Chronic back pain may also result from sudden injury to the cervical spine and lumbar spine, muscular irritation, and muscle spasms. To relieve pain, you have to strengthen weak muscles and avoid muscle overuse.

Spinal Cord Abnormalities

Conditions like herniated discs, osteoarthritis, spinal cord infection, or spinal stenosis can contribute to upper back pain. These conditions can cause compression or irritation of the nerves in the upper back, resulting in pain and discomfort. In addition, poor ergonomics and prolonged sitting or standing in a hunched position can also contribute to spinal cord abnormalities and upper back pain. 

Nerve Compression

Pinched nerves in the upper back can cause radiating pain, numbness, or tingling. This can occur when the surrounding muscles or tissues pressure the nerves, leading to their compression. Activities involving repetitive movements or heavy lifting can also increase the risk of nerve compression in the upper back. 

Organ Issues

Problems with organs like the heart, lungs, or gallbladder can refer to pain in the upper back region. For example, a heart attack can cause pain that radiates to the upper back. Similarly, conditions such as pneumonia or gallstones can also result in upper back pain as a symptom. 

What are the red flags for upper back pain?

Certain signs suggest that upper back pain might indicate a more serious issue. These red flags include persistent pain that worsens over time, unexplained weight loss, difficulty breathing or shortness of breath, and neurological symptoms such as weakness or loss of coordination. Other red flags for upper back pain include a history of cancer, recent trauma or injury to the upper back muscles alone, and pain accompanied by fever or night sweats.

Sudden Intensity

If your pain suddenly becomes severe without an apparent cause, it could indicate an acute problem. It is important to seek immediate medical attention in such cases, as it could indicate a serious condition such as a spinal infection or a ruptured disc. Ignoring sudden intense pain may lead to further complications and delay proper treatment. 

Loss of Bladder or Bowel Control

Difficulty controlling your bladder, bowels, and upper back pain, requires immediate medical attention. This combination of symptoms could indicate a serious condition such as cauda equina syndrome, a medical emergency. Prompt medical intervention is crucial to prevent permanent damage or paralysis.

Fever and Infection

High fever, chills, and signs of infection alongside upper back pain might indicate an underlying infection or inflammation. In some cases, antibiotics or other treatments may be necessary to address the underlying cause and alleviate the symptoms. 

Neurological Symptoms

Weakness, numbness, or tingling in your arms or legs could suggest nerve compression or damage. If left untreated, nerve compression or damage can lead to long-term complications and affect your ability to perform daily activities. 

How can you tell if back pain is muscular or something else?

Determining the source of your upper back pain is crucial for effective treatment. Muscle tenderness or stiffness may accompany the pain if it is muscular. However, suppose the pain persists or is accompanied by other symptoms such as difficulty breathing or chest pain. In that case, it is important to seek medical advice as it could indicate a more serious condition such as a heart problem. Here’s how you can differentiate between muscular pain and other types:

Muscular Pain

Muscular pain is often localized and worsens with movement. It might feel like aching, soreness, or stiffness. Other common symptoms of muscular pain include swelling or bruising in the affected area, limited range of motion, and muscle weakness. Resting and applying ice or heat to the area is important to help alleviate the discomfort. 

Nerve Pain

Nerve-related pain frequently radiates down the arm and comes with numbness, tingling, or burning sensations. Nerve pain can be caused by various factors such as nerve compression, injury, or underlying medical conditions like diabetes or neuropathy. Identifying and addressing the root cause of nerve pain is crucial to manage and treat it effectively. 

Pain in the Thoracic Spine

Thoracic spine pain stemming from spinal issues might feel deep, and constant, and worsen with certain positions or activities. Herniated discs, spinal stenosis, and degenerative disc disease are some conditions that can cause thoracic spine pain or spinal pain. Physical exam, therapy, medication, or surgery may sometimes be necessary to alleviate the thoracic spine pain and improve overall spinal health. 

Organ-Related Pain

Pain from organs can feel like a dull ache or pressure, and it frequently comes with additional symptoms about the specific organ’s function. For example, kidney pain may be accompanied by urinary symptoms such as frequent urination or blood in the urine. Similarly, liver pain may be associated with jaundice or digestive issues. It is important to consult a healthcare professional to accurately diagnose and treat organ-related pain, as it can indicate underlying medical conditions that require attention. 

Can upper back pain be heart-related?

While upper back pain is often musculoskeletal, it can sometimes be related to heart health. For example, upper back pain can be a symptom of a heart attack, especially in women. Shortness of breath and chest discomfort are frequently present along with this type of pain, which may radiate to the jaw, neck, or left arm. It is important to seek immediate medical attention if upper back pain is severe or accompanied by these symptoms. Symptoms of heart-related upper back pain include:

Radiating Pain

Heart-related pain may radiate to the upper back, neck, or jaw. This type of pain often starts in the chest and spreads to these areas, indicating a potential heart problem. Other symptoms, such as dizziness, nausea, and sweating, may also be present in heart-related upper back pain cases. 

Breathing Issues

If you are having trouble breathing along with your upper back pain, this may indicate heart-related problems. This could be a sign of reduced blood flow to the heart, causing the heart to work harder and resulting in upper back pain and shortness of breath. 

Chest Pain

Sometimes, heart-related pain might be felt as discomfort in the chest, upper back, or both. This can result from the heart muscle not receiving enough oxygen, leading to angina or a heart attack. 

Exercise-Related Pain

It’s crucial to consider heart health if your upper back pain is exercise-related and goes away with rest. This type of pain could indicate a potential issue with the heart, such as a blocked artery or poor blood circulation. It is important to consult a healthcare professional to rule out any underlying heart conditions and ensure proper treatment and prevention measures are taken.

Treatment for back pain: Prolotherapy

In recent years, prolotherapy has built its reputation within the medical community due to its clinically proven ability to treat back pain.

Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.

Prolotherapy involves injecting a natural regenerative solution with small needles. This has been shown to reduce swelling, which helps with back pain.

As prolotherapy is helping to treat the root cause of back pain, it is deemed to be a permanent fix, preventing the symptoms from returning.

Why Won’t My Upper Back Pain Go Away?

A healthcare professional should assess persistent upper back pain that does not improve over time or with treatment because it may indicate an underlying heart condition. Additionally, it is important to rule out other potential causes of the pain to ensure an appropriate diagnosis and treatment. Here are a few common reasons why it might not go away:

Underlying Condition

If your pain is a symptom of an underlying condition like a herniated disc or spinal issue, addressing the root cause is essential. This may involve physical therapy, medication, or even surgery, depending on the severity of the condition. Another possible reason for persistent upper back pain is poor posture or ergonomics. Adjustments to your workstation or practicing good posture habits help alleviate the pain over time. 

Improper Treatment

Inadequate or incorrect treatment methods can lead to unresolved pain. It is important to seek professional medical advice and follow the recommended treatment plan for upper back pain. Additionally, self-medicating or relying solely on over-the-counter pain relievers may provide temporary relief but may not address the root cause of the pain. 

Repetitive Strain

Continuing activities that strain the muscles can hinder the healing process. It is crucial to identify and modify any repetitive movements or postures that may be contributing to upper back pain. Taking regular breaks, practicing proper ergonomics, and incorporating stretching and strengthening exercises can help prevent further strain on the muscles and promote healing. 

Poor Posture and Stress

Emotional stress and tension can contribute to muscle tightness and exacerbate upper back pain. Finding healthy ways to manage stress, such as practicing relaxation techniques or seeking support from a therapist, can help alleviate muscle tension and promote healing in the upper back. Additionally, incorporating stress-reducing activities into daily routines, such as exercise or hobbies, can aid healing. 


Upper back pain can range from a minor annoyance to a sign of a more serious underlying condition. While many cases are due to muscular strain, it’s important to be aware of red flags and potential heart-related issues. Understanding the source of your pain, differentiating between types of pain, and seeking appropriate medical attention when necessary are essential steps in managing and alleviating upper back pain. Remember, proper posture, regular exercise, and stress management can also be crucial in maintaining a healthy upper back and preventing future discomfort.


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