Upper back pain may be due to poor posture, muscle overuse, an injury, or a herniated disk. Other possible causes include lung cancer, osteoarthritis, and a spinal infection. Treatment can depend on the cause.

12 bones comprise the upper back, which doctors call the thoracic spine. The first bone of the upper back begins at the base of the neck, and the 12th bone ends just below the ribcage. Upper back pain can appear anywhere between these bones.

This article explores the common cause of upper back pain and what people can do to prevent or ease it.

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Yakov Knyazev/Stocksy United

Doctors often call upper back pain thoracic spine pain or TSP. Common causes include the following:

Muscle deconditioning and poor posture

Poor posture and a sedentary lifestyle can cause muscles in the back to weaken or decondition.

For example, slouching in a chair over a desk may cause a gradual loss of strength in the upper back muscles and increase the likelihood of strains. Over time, poor posture can also increase the curvature of the thoracic spine – leading to pain.

Muscle overuse

Overusing back muscles is another common cause of upper back pain.

Common causes of muscle overuse in the upper back include:

  • throwing movements in sports, such as pitching in baseball
  • repetitive lifting with poor form
  • repetitive twisting motions in the upper body

Repeating these movements often over time, without giving the body ample time to recover, will gradually weaken the muscles and can eventually lead to :

  • muscle strain
  • tightness
  • irritation

Traumatic injury

A traumatic injury can also lead to back pain. This may be the result of situations that include:

  • car accidents
  • slipping and falling
  • work-related accidents
  • lifting incorrectly
  • working out too hard

The injury is sometimes obvious, and the pain appears just after the incident. At other times, the pain may not develop until later or the next day.

Traumatic injuries can be severe, and issues from injuries, for example, fractured vertebrae, put a person at risk of lasting complications, including chronic pain, nerve damage, and paralysis.

Herniated disc

Herniated discs are more common in the lower back but may sometimes happen in the upper back, too.

Discs are the soft, rubbery cushions between each vertebra. Herniated discs occur when a piece of this cushion pokes through and puts pressure on the spine.

Even a small amount of pressure can result in significant pain in the middle of the back, as well as other symptoms, including numbness or weakness in the arms or legs.

Pinched nerve

A herniated disc can slip far enough out to compress a nearby nerve. A pinched nerve in the middle back may cause:

  • numbness and pain in the arms or legs
  • problems with controlling urination
  • weakness or loss of control in the legs


Scoliosis is an abnormal sideways curvature of the spine. This curvature can stretch and irritate nerves, and alter spinal disc placement. Both of these can cause pain in the area where curvature is most pronounced.


The source of back pain is sometimes not the muscles but a problem in the bones and joints.

The cartilage that cushions and protects the bones may wear down as a person ages. The term for this is osteoarthritis. It is the most common form of arthritis among older adults.

Osteoarthritis may eventually lead to cartilage between the bones completely wearing away, causing the bones to rub together. This can also put pressure on the nerves in the spine, causing numbness or tingling in the arms and legs.

Learn more about the different types of arthritis in our dedicated content hub.

Myofascial pain

Pain may also stem from problems in the connective tissue in the back, which doctors call the fascia. Myofascial pain may begin after an injury or overuse, but chronic myofascial pain may last long after the initial injury.

Spinal infection

Rarely, an infection may be the cause of upper back pain. A spinal epidural abscess is a collection of germs and pus that form between the spinal cord and bones of the spine.

The abscess can grow and swell, leading to pain. Early diagnosis is critical, and doctors will treat a spinal abscess quickly to avoid serious complications.

Lung cancer

In rare cases, back pain can occur when cancerous cells proliferate in the spine. This can occur in many different types of cancer, including breast and lung cancer.

Tumors between the vertebrae can compress spinal nerves and disrupt disc placement.

Learn more in our dedicated cancer hub.


Fibomyalgia is a chronic condition that can cause widespread pain and sensitivity in the body. THe condition can affect any part of the body can can cause throbbing, aching, or burning pain sensations.

It may not be possible to prevent all causes of upper back pain, but there are some easy steps people can take that may avoid some of the more common causes. These include:

  • Taking frequent breaks when sitting to get up and stretch.
  • Warm up before exercise.
  • Lifting with proper, safe form.
  • Working with a physical therapist to strengthen weak muscles, if necessary.
  • Practicing correct posture at all times.

A person’s options for relieving back pain will depend on its underlying cause.

For example, pain muscular strains and sprains may lessen with stretching and proper posture, but this will not help chronic nerve pain.

Limiting pressure on the affected area, over-the-counter pain medications, and topical pain relievers can help relieve pain symptoms in chronic cases, but will not remedy the cause.

In cases of trauma or chronic back pain, people should see a doctor for a proper diagnosis. Anyone uncertain where to begin should ask their doctor about their pain and treatment options. They may recommend specific exercises or refer a person to a physical therapist.

Most cases of back pain appear because of lifestyle issues, such as weak or overused muscles from repetitive behaviors. In these cases, lifestyle changes, such as regular exercise and stretching, may help relieve pain.

Read the article in Spanish.