Causes of upper back pain between shoulder blades

• Overview
• Possible Causes
• Care and Treatment

Overview

What is upper back pain?

Upper back pain (and middle back pain) occurs anywhere from the base of your neck to the bottom of your rib cage. Your upper and middle back is called the thoracic spine. Your thoracic spine has 12 small bones called vertebrae. Your vertebrae form your backbone.

Each of the vertebrae on your thoracic spine is connected to a pair of ribs. Your ribs wrap around your body to a long, flat bone down the center of your chest called the sternum. This forms your rib cage.

Your upper back also has disks that separate each vertebrae. These disks absorb shock as you move. There are also many muscles and ligaments in your upper back that hold your spine together. Upper back pain may be caused by many different medical issues or injuries to the bones, disks, muscles and ligaments in your upper back.

Upper back pain is not as common as neck pain or low back pain. This is because the bones in the upper area of your back don't move or flex as much as the bones in your neck and lower back. The bones in your upper back work with the ribs to keep the back stable. They work together to help protect vital organs in your body including your heart and lungs.

Possible Causes

What are the possible causes of upper back pain?

Upper back pain may be caused by many different medical conditions and injuries. Conditions that may cause upper back pain include:

• Strains and sprains: Back strains and sprains are the most common cause of upper back pain. You can injure muscles, tendons or ligaments by lifting something too heavy or not lifting safely.
• Poor posture: Many people with upper back pain find it hard to stand up straight. You may stand “crooked” or bent, with your torso off to the side rather than aligned with your spine.
• Disk problems: Disks can slip or “bulge” from their position in the spine and press on a nerve. They can also tear (herniated disk).
• Fractures: The bones in the spine can break during an accident, like a car crash or a fall.
• Arthritis: Osteoarthritis is the most common type of arthritis that causes upper back pain.

What does upper back pain feel like?

People describe the feeling of upper back pain in many different ways. Some people describe upper back pain as feeling like:

• A burning or sharp pain.
• An achy, throbbing pain.
• Muscle tightness or stiffness.
• A radiating pain along a nerve.
• Tingling, numbness or weakness.

Care and Treatment

How is upper back pain diagnosed?

Your healthcare provider will ask you questions about your medical history, activity level and symptoms. They will also ask you questions about your pain. These questions may include:

• When did the pain start?
• Where does the pain hurt the most?
• Does anything you do make the pain feel better?
• Does anything you do make the pain feel worse?

Your healthcare provider may do a physical exam. They may have you lift or bend your legs to see how moving affects your pain. Your healthcare provider may test your muscle strength and reflexes.

Depending on what your healthcare provider finds, they may order additional tests. These tests may include:

• Spine X-ray: Uses radiation to produce images of the bones in your spine.
• Magnetic resonance imaging (MRI) scan: Uses a magnet and radio waves to create pictures of your bones, muscles, tendons and other soft tissues in your spine.
• Computed tomography (CT) scan: Uses X-rays and a computer to create 3D images of the bones and soft tissues in the spine.
• Electromyography (EMG): Tests the nerves and muscles in your spine and checks for nerve damage (neuropathy), which can cause tingling or numbness in your legs.
• Blood test: Can detect genetic markers for some conditions that cause back pain.

How is upper back pain managed or treated?

Your treatment will depend on the causes and symptoms of your pain. People with mild to moderate upper back pain can usually manage their symptoms at home. You can try managing your symptoms with:

• Over-the-counter pain medications such as acetaminophen (Tylenol®) and nonsteroidal anti-inflammatory drugs (NSAIDs).
• Heating pad to reduce pain and stiffness.
• Ice pack to reduce pain and swelling.
• Medical massage.
• Getting plenty of rest.

What else can I do at home to prevent or reduce upper back pain?

There are many ways you can prevent or reduce upper back pain at home. Additional ways include:

• Exercise: Exercise can help stretch and strengthen your upper back muscles.
• Good posture: Stand and sit tall. Don't slump or slouch.
• Reduce stress: Try deep breathing, relaxation exercises or meditation.

When should I call my healthcare provider if I have upper back pain?

Upper back pain usually gets better on its own. Call your healthcare provider if:

• Your upper back pain doesn’t improve after a week.
• You develop any tingling or numbness in your legs or buttocks.
• You have severe pain or muscle spasms.
• You develop new symptoms such as fever, weight loss or bowel or bladder problems.

These may be a sign of a more serious condition.

A note from Cleveland Clinic

Upper back pain may not be as common as lower back pain, but it can still greatly affect your quality of life. While you can’t always avoid upper back pain, there are ways to help prevent it. Make sure to stand up straight, get plenty of exercise and try to reduce your stress. If your pain doesn’t improve, call your healthcare provider. They can help you figure out what’s causing you pain and get you back on track.

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Last reviewed by a Cleveland Clinic medical professional on 04/26/2022.

References

• MedlinePlus. Back Pain. (https://medlineplus.gov/backpain.html) Accessed 4/26/2022.
• National Institutes of Health. Back Pain. (https://www.niams.nih.gov/health-topics/back-pain#tab-diagnosis) Accessed 4/26/2022.
• PeaceHealth. Upper and Middle Back. (https://www.peacehealth.org/medical-topics/id/aba5320) Accessed 4/26/2022.

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