When Should I Worry About Upper Back Pain?

Upper back pain is most commonly a result of exercise or overuse inflaming the muscles. More seriously, it can be a sign of a torn ligament, fractured or compressed disks or vertebrae, or a pinched nerve.

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

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 
  • Steroids can lead to bone loss, so a doctor may suspect a fracture  
• 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