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When Should You Worry About Upper Back Pain?

By Arielle Mitton

Medically reviewed

February 15, 2022

If you spend any extended time hunched over a computer or phone, chances are you’ve experienced some form of upper back pain. While this part of the back (also known as the thoracic spine) is less susceptible to injury than the lower or middle back, upper back pain still affects nearly one in 10 men and one in five women.

And with a range of symptoms, pain levels, and causes, it’s not always clear when to see a doctor.

Most cases of upper back pain can be managed at home with over-the-counter pain medication, heat or ice, exercise, and improvement of posture. However, certain symptoms in conjunction with upper back pain may indicate a serious medical issue that requires immediate attention from a healthcare professional.

In this article, I’ll detail the symptoms and potential causes of upper back pain. Then I’ll break down the potential signs that upper back pain could be something serious and when to see a doctor.

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Symptoms of Upper Back Pain

Common symptoms associated with upper back pain include:

Stiffness in the back
Aching or burning between the shoulder blades
Pain in the upper back when breathing deeply
Chest pain or tightness
Neck pain
Indigestion

What Causes Upper Back Pain?

Although it can be difficult to determine the exact cause of upper back pain, common possible causes include:

Muscle strain, sprain, or overuse: Repetitive movements, such as those from physical labor, can lead to muscle and ligament injuries. Improper lifting technique can also result in upper back pain.

Poor posture: Slouching in a chair, hunching over a phone, or standing with the pelvis tucked under or out can all lead to upper back pain.

Disc or nerve damage: Discs are the soft “shock absorbers” between vertebrae. If ruptured or herniated, the discs bulge, putting pressure on the spinal nerves and triggering pain that often radiates.

Fractured vertebrae: Accidents can cause bones in the spine to break, impairing movement.

Osteoarthritis: Though more common in the neck and lower back, this “wear and tear” type of arthritis can happen in the upper back as well. Osteoarthritis occurs when cartilage breaks down.

Osteoporosis: Weak, brittle bones are more susceptible to fractures.

Other conditions and lifestyle factors that can contribute to upper back pain include:

Smoking
Lack of physical activity
Excess body weight
Depression and anxiety
Fibromyalgia
Paget’s disease

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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 you’re losing weight without changes to your diet or lifestyle while experiencing upper back pain, it could be the result of a tumor or infection.

A slowing in the reaction time of arms and legs: When associated with upper back pain, a tingling or delayed reaction time of the arms and legs could be signs of cervical spondylotic myelopathy (CSM). CSM is the compression of the spinal cord. When the spinal cord is pinched, this can delay messages that the brain sends to the arms and legs to cause them to react and move. CSM is a degenerative process that can happen as we age. On average, people who have it are in their 50s or 60s.

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.

When to See a Doctor

If you have any concerns about upper back pain, or if you have back pain from a fall, injury, or accident, consult a doctor.

Also seek medical attention if you have any of the following symptoms in conjunction with upper back pain:

Weakness or numbness in one or both legs
Fever without flu-like aches
Pain that wakes you up for more than three nights of sleep
Back pain that persists after 4-6 weeks
Severe back pain that does not go away after a few days of treatment (such as ice, pain relievers, and rest)
Pain that shoots down one leg below the knee
Chronic upper back pain lasting longer than six weeks that prevents you from doing daily activities
Numbness in the upper inner thigh, groin, buttok, or gential areas

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Frequently Asked Questions

How do you know when upper back pain is serious?

If you experience acute upper back pain from a fall, car accident, or other injury, seek medical attention immediately. Another indicator that upper back pain is serious is if you’re experiencing additional symptoms, some of which include fever (without flu-like aches), ongoing back pain, pain that wakes you up from sleep for more than three consecutive nights, weakness or numbness in the legs, back pain that lasts longer than 4-6 weeks, and radiating back pain.

When should I worry about upper back pain between shoulder blades?

Call your doctor immediately if you are experiencing severe upper back pain between the shoulder blades, as it may be signs of a serious medical condition, such as lung disease, heart disease, blood vessel disease, or gallstones.

What organs can cause upper back pain?

Organs that can cause upper back pain include the gallbladder, kidneys, and pancreas. The gallbladder can cause upper back pain between shoulder blades if gallstones, an accumulation of hard pieces of digestive fluids, have formed. Kidney problems such as kidney stones can also cause upper back pain. Additionally, a symptom of pancreatic cancer is a dull pain that occasionally occurs in the upper back.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Arielle Mitton

Dr. Mitton is a board certified internal medicine physician with over 6 years of experience in urgent care and additional training in geriatric medicine. She completed her trainings at Mount Sinai Hospital and UCLA. She is on the board of the Hyperemesis Research Foundation to help women suffering from hyperemesis gravidarum.

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