Upper back
Upper back pain between the shoulders calls for a doctor's visit
Back pain usually improves within a few weeks, but pain coming from the top of the back, between the shoulders, is a reason to see a doctor [1]. This page covers common causes, home care, and the signs that need emergency care or prompt medical attention.
Key points
- Back pain overall is very common and usually improves within a few weeks, though it can last longer or come back [1].
- Pain coming from the top of the back, between the shoulders, is a reason to see a doctor [1].
- A pulled muscle, called a strain, is a common cause of back pain [1].
- Staying in bed for more than 1 or 2 days can make back pain worse [2].
- Back pain with numbness around the genitals or anus, bladder or bowel changes, or symptoms in both legs needs emergency care [1].
Back pain between the shoulders is a reason to see a doctor
Pain coming from the top of your back, between your shoulders, rather than your lower back, is on the list of reasons to see a doctor [1]. That is true even though back pain in general often gets better on its own [1].
Other reasons to get the pain checked are below [1].
- The pain does not improve after treating it at home for a few weeks [1].
- It stops you doing your day-to-day activities [1].
- You are worried about the pain or struggling to cope [1].
- You have lost weight without trying to [1].
- You notice a lump or swelling in your back, or your back has changed shape [1].
- It does not improve after resting, or it is worse at night [1].
- It is worse when you sneeze, cough or have a bowel movement [1].
Another source advises calling your health care provider if back pain is severe or does not improve after three days [2].
A pulled muscle is one common cause of back pain
A common cause of back pain is an injury such as a pulled muscle, called a strain [1]. It is not always obvious what causes back pain, and it often gets better on its own [1].
Posture and office setup appear among the standard prevention topics for back pain [2]. Repetitive movement may also matter in some sports. In basketball, the many throws and dribbles in a session may promote pain or injury in the spine [3].
| Possible source | What to know |
|---|---|
| Strain | A common cause of back pain [1] |
| Medical conditions | A slipped disc, sciatica (a trapped nerve) or ankylosing spondylitis can cause back pain [1] |
| Facet joints in the thoracic spine | These joints account for pain in over 25% of people with chronic mid-back and upper-back pain [4] |
| Repetitive sport movement | Throws and dribbles in basketball may promote spine pain [3] |
| Serious problem | A broken bone, cancer or infection is a very rare cause [1] |
Staying active and using heat or ice can ease back pain at home
- Stay active and continue your daily activities [1].
- Do not stay in bed for long periods. More than 1 or 2 days in bed can make back pain worse [2].
- Wrap an ice pack or a bag of frozen peas in a towel to reduce pain and swelling [1].
- Wrap a heat pack in a towel to relieve joint stiffness or muscle spasms [1].
- Anti-inflammatory medicine such as ibuprofen may help, but it may not be suitable for everyone. A pharmacist can help you choose a suitable painkiller [1].
- Walking, swimming, yoga and pilates may also help ease back pain [1].
- Try exercises and stretches for back pain. If the pain gets worse, stop and get medical advice [1].
- Advice written for shoulder pain suggests standing up straight with your shoulders down and gently back, and sitting with a cushion behind your lower back [5].
Common mistake
Resting in bed for days feels natural, but it can make back pain worse [2].
When to get care
Back pain with numbness or bladder changes needs emergency care
Back pain together with any of these signs needs emergency care [1]:
- Pain, tingling, weakness or numbness in both legs [1].
- Loss of feeling around the genitals or anus [1].
- Bladder or bowel changes, such as trouble urinating or losing control of urine or stool [1].
- Changes in how the genitals feel during sex, or trouble getting or keeping an erection or reaching orgasm [1].
- Chest pain [1].
- Pain that started after a serious accident, such as a car crash [1].
Do not drive yourself to the emergency room. Ask someone to drive you [1]. Bring any medicines you take with you [1].
If you think you may have a medical emergency in the United States, call 911 or go to the nearest emergency room.
Sudden severe back pain needs prompt medical attention
Get prompt medical attention if you have back pain and you feel hot, cold, shivery or generally unwell [1]. The same applies to severe pain that starts suddenly or is getting worse quickly [1].
Back pain that follows an injury also calls for medical attention [2].
Physical therapy and nerve procedures are options when back pain lasts
Other treatments may be recommended if back pain does not get better after a few weeks [1].
| Option | What to know |
|---|---|
| Group exercise and physical therapy | Listed as treatments if pain lasts beyond a few weeks [1] |
| Manual therapy | A trained therapist massages and moves the muscles, bones and joints in your back [1] |
| Cognitive behavioral therapy | Helps you cope with the pain [1] |
| Radiofrequency ablation | Uses heat to damage nerves and interrupt pain signals. Research in the mid and upper back is limited, and larger studies are needed [4] |
| Surgery | May be an option when a condition like a slipped disc is the cause and other treatments have not helped [1] |
In teenagers with low back pain, group exercise, and spinal manipulation added to exercise, may reduce pain. The evidence is sparse, and that review found no studies of mid-back pain in young people [6].
Sources
- Back pain nhs.uk
- Back Pain medlineplus.gov
- Prevalence and Risk Factors of Musculoskeletal Disorders in Basketball Players: Systematic Review and Meta-Analysis Healthcare (Basel, Switzerland)
- Advances in radiofrequency ablation for thoracic spine pain Annals of palliative medicine
- Shoulder pain nhs.uk
- Rehabilitation of back pain in the pediatric population: a mixed studies systematic review Chiropractic & manual therapies
Not medical advice. This page is general education written from the sources above. It cannot diagnose a condition or replace a licensed clinician who knows your history. If you may be having an emergency, call your local emergency number or go to the nearest emergency department.