The Top 5 Causes of Upper Back Pain

Whether as a result of a sedentary lifestyle, extreme stress, or the strain of a non-ergonomic work environment, most us have felt the effects of back pain at one time or another. And those who haven’t yet likely will at some point during their lives.

While lower back pain is often assumed to be the culprit in the thousands of missed hours of work and millions of dollars of treatment poured into back pain every year, pain the upper back, neck, and shoulders actually contribute greatly to the overall total.

So what’s causing upper back and neck pain? The thoracic (mid) spine has a more limited range of motion than either the cervical spine (neck) or lumbar spine (lower back). As a result of this overall stability in the thoracic spine area, many of the common spinal disorders that affect the lower back or neck are very rare in the thoracic spine, such as herniated discs or spinal stenosis.

Muscle Irritation or Sprain

Have you ever taken a harder hit than expected during a rousing game of ultimate Frisbee in the park and had a hard time moving your shoulder the next day, or slept on a strange mattress overnight and not been able to turn your head when you awoke?

This stiffness and pain in your neck and upper back is a result of a simple muscular irritation or strain. Often due to lack of strength, overuse, or repetitive motion, it’s essentially no different than twisting an ankle or pulling a calf muscle.  A little rest, perhaps some hot and cold compress, an over counter painkiller and you’re good as new in a few days.

Poor Posture or Ergonomics

Another leading culprit of upper back pain is poor posture and/or poor ergonomics, particularly among desk and computer workers. The human body simply wasn’t made to sit at a desk, and spending 8-10 hours every day in front of a computer slouching, having the keyboard and monitor set in the wrong position, or not providing proper back support exacerbates an already bad situation.

Poor posture is also a major contributor to back pain. Often a result of obesity or a general lack of core strength, poor posture causes the neck to be constantly bending forward in order to compensate with balance. This constant strain on the neck muscles causes pain in the neck, shoulders and upper back.


We hear it all the time, the effects of stress on the body. From the constant overproduction of certain hormones, to inefficiency in processing fat stores, to exhaustion and depression, stress is very, very hard on our bodies.

In our backs, stress – particularly sustained stress – causes muscles to tighten, which can create painful spasms. Stress also causes the shoulders to ride up, hunching up toward the neck and pinching muscles and nerves.

Stress relief is critically important not just for back pain, but also for overall health. Meditation, exercise and changes in lifestyle such as sleeping 8 hours a night, and even a less demanding job can dramatically decrease your instances of upper back pain.


Trauma, from whiplash to lifting injuries, causes damage to muscles, ligaments and tendons, overstretching them and causing extreme soreness and pain. It can take months for the damage to heal, and even then the area can be somewhat weakened and prone to re-injury.

Degenerative Disease

Lastly, degenerative disease such as arthritis can cause painful changes in the cervical and thoracic areas of the spine. Early morning stiffness or a sensation of grinding can be indicative of arthritic changes. In more severe cases symptoms can include, weakness, numbness or tingling in the extremities, loss of bowel or bladder control, and lack of coordination.

We can do a lot to prevent, or at least decrease the severity of pain in the upper back, neck and shoulders with a few simple lifestyle changes. Being mindful of our stress level and taking action to reduce it, ergonomic workstations, core strengthening, aerobic exercise, and stretching are all highly effective preventative measures.