What Causes Upper Back Pain?

Upper back pain is a phenomenon that affects all age groups.

Your upper back (or thoracic spine) is that portion of your spine between your neck and your abdomen, roughly parallel to your chest. It is the largest portion of the spine, consisting of 12 of the 24 vertebrae.

For comparison, the neck has 7 vertebrae, while the lower back has 5 vertebrae. All of the thoracic vertebrae articulate with ribs and together protect the thorax.


Upper back pain is not as common as lower back pain or neck pain, because the bones in this area of the back don’t flex or move as much as the bones in your lower back or neck.

Two Main Causes

Your upper back is there to provide stability. Since it has fewer moving parts, it’s less susceptible to strain, or to degenerative conditions like bulging or herniated discs. Only about 1% of all disc herniations occur in the thoracic spine. The vast majority of cases of upper back pain are due to Muscular Irritation and Joint Dysfunction.

Because the pain is related to large muscles in the shoulder area, most rehabilitation plans will include a great deal of stretching and strengthening exercises.

1. Muscular Irritation

The shoulder girdle attaches by large muscles to the scapula and the back of the thoracic rib cage. These large upper back muscles are prone to developing irritation (myofascial pain) that can be painful and difficult to work out.

Myofascial pain can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension. Muscle strains, sports injuries, car accidents or other injuries can all result in pain from muscular irritation. Often, muscular irritation and upper back pain are due to either de-conditioning (lack of strength) or overuse injuries.

2. Joint Dysfunction

The cause of strain or joint dysfunction is usually stress of one kind or another. Physical stress, such as stooping over your desk for hours at a time, can be an obvious cause. Less evident is the mental or emotional stress that comes from worrying about finances or grieving over a loss. Mental/emotional stress can lead to tensed shoulders and shoulder blades, irritating nerves in the thoracic spine and causing back pain.


Just as with pain in the lower back, upper back pain can be the result of a number of different factors. There are certain factors in your life (such as not enough exercise, overweight, sitting for too long…) which may contribute to your upper back pain, by repeatedly stressing one area of your back.

If you’re suffering from upper back pain, make sure you consult with a specialist before beginning any treatment. If you can get the problem diagnosed early, your back pain will quickly become a thing of the past.

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