What Can Cause Upper Back Pain?

Upper back pain, also called thoracic spine pain, usually has a musculoskeletal origin and is related to poor posture or overuse injuries.
Causes of upper back pain may include:
- Overworked muscles
- Injuries to the vertebrae
- Damage to the vertebral discs
- Wear and tear of cushioning between the vertebrae (with age)
- Degenerative bone disease
When Should I Worry About Upper Back Pain?
Much of the time, upper back pain is not serious, but in some cases, it may be a sign of a medical issue that needs to be addressed.
See a doctor if the upper back pain is:
- Sharp, rather than dull: Could be a sign of a torn muscle or ligament, or a problem with an internal organ in the back or side
- Radiating to the buttocks or legs: may be a sign of nerve compression or damage
- Associated with deep inhalations: could be a sign of an infection or blood clot in lung
- Associated with pain in the chest or upper abdomen: could be a sign of problem with the aorta (the main artery that carries blood from the heart) or gallbladder
Also see a doctor if you have upper back pain accompanied by any of the following symptoms or any of the following underlying conditions:
- Trauma
- Such as a motor vehicle accident or a fall from a height
- If you are over age 50 and have a minor accident, see a doctor because even minor trauma may cause a fracture
- Fever
- May be a sign of infection
- Numbness or tingling
- May indicate nerve irritation or damage
- Can be a sign of a herniated disc, spinal stenosis, or sciatica
- If left untreated, prolonged nerve irritation and damage can lead to permanent impairment
- If numbness or tingling occurs in the groin or glutes, it’s called saddle anesthesia and is a sign of a serious nerve or spine condition
- Sudden weakness in the legs
- May be caused by compressed nerves
- Sudden leg weakness could also indicate a stroke
- Loss of bowel or bladder function
- Can be a sign of a rare and serious condition called cauda equina syndrome, in which the nerve roots in the lower end of the spinal cord have become compresses and paralyzed
- Cauda equina syndrome is a medical emergency that requires immediate attention
- May result from a herniated disk, fracture, tumor, spinal stenosis, or trauma to the spine
- Symptoms of cauda equina syndrome may also include numbness and weakness of the legs
- Loss of bowel or bladder function may also be a sign of serious nerve compression or a spine infection, such as discitis or meningitis
- Foot drop
- Usually a symptom of a nerve problem, muscle problem, or a brain problem
- Pain at night
- Can be a sign of disc degeneration or a sprain, or something serious such as cancer or a tumor
- Unexplained weight loss
- Could be caused by infection or a tumor
- Prolonged pain (6 weeks or more)
- Most back pain gets better within six weeks; see a doctor if pain persists longer because there may be a more serious underlying cause
- Medical history of cancer
- Need to rule out spread (metastases) of cancer
- Suppressed immune system
- Need to rule out an infection as the cause
- Osteoporosis
- Back pain may be caused by fracture due to weakened bones
- Chronic steroid use
- Age over 70 years
- Elderly people have an increased risk for infection, tumors, and abdominal causes of back pain
- Prolonged use of IV drugs
- Can make people more susceptible to infection

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Reviewed on 11/12/2020
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