Many cases of upper back pain (or mid-back pain) are caused by problems affecting the soft tissues in your spine (eg, muscles, nerves, ligaments, and tendons). Sprain, strain, and muscle tension are common soft tissue injuries that may cause pain and other symptoms in your upper and middle back. This article describes symptoms of upper back pain, including the red flags you should never ignore.

Most Upper Back Symptoms Relate to Your Spinal Muscles

Because upper pain is closely linked to soft tissue injuries, the most common symptoms affect your spinal muscles:

  • Stiffness
  • Spasm
  • Pain (ranging from dull to sharp)
  • Tightness
  • Tenderness when the injured area is touched
  • Headache

Some people with upper or mid-back pain feel pain when they sneeze or cough. Similarly, you may also feel upper back pain when you take a deep breath because the vertebrae (the spinal bones) in your upper back (also known as the thoracic spine) are connected to the ribs. However, severe pain when breathing may be a sign of a more serious medical condition (you can read more on this below).

Though upper back pain symptoms generally occur anywhere along the spine between the base of the neck (cervical spine) and bottom of the ribs, you may also feel upper back pain in your shoulders and neck. That’s because all your muscles are connected, so if it’s a muscle problem causing your upper back pain, the other muscles in your shoulders and neck can be affected.

Upper back pain symptoms can stem from several causes. Poor body mechanics, twisting movements, poor posture, improper lifting techniques, carrying a heavy load (eg, wearing a heavy backpack), or repetitive movements are common culprits. Traumatic events (eg, a fall or car accident) may also lead to upper back pain. But there are many other possible causes of upper back pain, and your doctor will help determine the underlying cause of your pain to find the solution.

In most cases, upper back pain does not indicate a serious medical problem. However, some symptoms warrant urgent medical care.

What Upper Back Symptoms Warrant a Trip to the Doctor?

Most bouts of upper back pain gradually go away on their own or with conservative at-home treatment (eg, over-the-counter medication). However, some symptoms are more serious than others and require swift medical attention.

Call your doctor if you experience any of the following upper back pain symptoms:

  • Severe, persistent upper or mid-back pain that develops suddenly
  • Pain that is progressively worsening
  • Pain that hasn’t gone away in a week
  • Pain that is interfering with your daily life (eg, forces you to call in sick to work)
  • Pain that isn’t responding to conservative treatment (eg, anti-inflammatory medication, ice/heat therapy, and massage)
  • Neurologic symptoms (eg, numbness, tingling, weakness, loss of bowel/bladder control, and/or electric shock-like pain in your arms and/or legs)

In rare cases, upper back pain is indicative of a serious and/or painful medical problem, including lung cancer, kidney stones, or spinal infection.

Additionally, because the thoracic spine is linked to the ribs, some people with upper back pain report sharp pain when filling their lungs with air to take a deep breath. Though this symptom may be benign, it could also be a sign of a blood clot. If you feel faint, short of breath, or a spike in upper or mid-back pain when you take a deep breath, see your doctor immediately to rule out a potentially life-threatening pulmonary embolism.

Finally, it’s especially important to see a doctor after you’ve endured a traumatic injury, such as a fall. Even if you aren’t experiencing any back pain, you should be evaluated by a physician to ensure your spine did not sustain damage (eg, a spinal fracture in your upper back).

Upper Back Symptoms: When in Doubt, See Your Doctor

Because the thoracic spine isn’t as susceptible to certain spinal disorders (namely those that affect the intervertebral discs and spinal joints) as the cervical spine or lumbar spine (low back), some people may think it’s immune to pain or other problems. This certainly isn’t the case.

Common symptoms of upper back pain—like muscle pain, stiffness, and tightness—are often caused by poor body mechanics or spinal injury. But in very rare cases, upper back pain is a sign of a more serious medical issue. If your upper or mid-back pain just won’t go away or if it’s interfering with your daily life, call your doctor. He or she will get to the root of your upper back pain, create a treatment plan for you, and help you learn ways to potentially prevent it in the future.

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