Pain in the High Back: Causes, Symptoms, Treatments, Warnings and Precautions

He reaches under the bed to put on a sock, and when he tries to stand, he finds he can not, without much effort and a lot of pain.

Back pain is a widespread problem that affects tens of millions of people each year.

Usually, the symptoms of back pain are caused by some minor tension or pull, and this is a short-term problem, but in some cases, it is a symptom of a severe illness.

The pain in the upper right part of the back is usually caused by a muscle or bone problem. However, the pain in this location is sometimes caused by a condition that affects an internal organ.

The body’s pain network sends impulses from the source of discomfort through the nerves to the brain. The pain of an internal organ can be experienced at the start of pain or another location due to shared nerve pathways.

This type of pain, known as referred pain, explains how a problem with an internal organ can cause pain in the upper back.

Other symptoms, a physical exam, and laboratory and imaging tests can help your doctor determine the cause of your upper right back pain.


Muscle pain in the upper back

Osteomielitis vertebral

The spread of bacteria causes the infection of the spinal bones ( vertebral osteomyelitis ) through the blood of another part of the body that falls on the spinal column.

It is usually caused by bacteria called Staph. Aureus (40-50% of the time), streptococci (12%), e.coli (9%) and Pseudomonas aeruginosa (6%).

It would help if you went to the emergency room, where a doctor will perform blood tests to detect inflammation and signs of infection. X-ray images are a typical first step, but magnetic resonance imaging is the gold standard.

If things are not clear yet, a biopsy may be needed to see what is happening in the spine. The treatment involves oral or blood antibiotics. Surgery is rarely required unless there is an implant in the back.

Wounded disk (slipped) in the upper part of the back

The spine is made up of 26 bones called vertebrae. Between the bones, there are soft discs filled with a gelatinous substance. These discs cushion the vertebrae and hold them in place.

Although people talk about a slipped disc, nothing gets out of place. The outer cover of the disc breaks, and the gelatinous substance bulges. It can press on a nerve, which is what causes the pain.

Slipping of the disc is more likely due to tension in the back, such as when lifting heavy objects, and older people are at greater risk.

To treat a slipped disc, you should consult with your primary care physician. Your doctor will perform a thorough physical examination to locate the slipped disc and rule out dangerous complications.

Most people do not require surgery for a slipped disc. The treatment is to relieve pain with over-the-counter pain medication, such as ibuprofen (Advil) and acetaminophen (Tylenol), heat treatments, and stay active.

It is best to avoid sitting for long periods. Walking or swimming can also help.

Thoracic exit syndrome

The thoracic outlet syndrome is the compression of the nerves and blood vessels that cross the upper part of the thorax. It can occur due to trauma, surgery, growth in the body, or simply at random.

You should seek medical attention early to determine if the compression is from the nerve or blood vessels. You may need X-ray images, computerized tomography of bloodstreams, or magnetic resonance imaging.

Treatment depends on the extent of the injury but usually includes physiotherapy. Surgical treatment may be required if a blood vessel is compressed.

Nerve pricked in the neck.

With age, the discs that separate the cervical vertebrae (which are the bones of the spine in the neck) lose height and also, lose water content and become stiffer.

The vertebrae move closer, and the nerves between these bones can be pinched, causing the pain to travel through the nerve as it passes through the arm.

The pain is usually acute, and some people report a “tingling” sensation or even complete numbness.

You should visit your primary care physician, who will coordinate your care with a bone and muscle specialist (orthopedic surgeon). Cervical radiculopathy is treated with analgesics, soft neck collars, and physiotherapy.

Myofascial pain syndrome

Myofascial pain syndrome is a chronic musculoskeletal syndrome caused by trigger points within the muscle. The pressure on these points causes pain in the area around the end, as well as in other parts of the body, a phenomenon known as referred pain.

It would help if you visited your primary care doctor. This complex chronic condition is often treated with injections and physical therapy.

Hematoma on the upper back

A bruise damages the blood vessels that return blood to the heart (the capillaries and veins), which causes the blood to accumulate. This explains the blue/purple color of most bruises.

Bruises on the back are expected, given how exposed this body area is.

You can treat this at home with DHCE – rest (exercise as tolerated), ice (10-20 minutes at a time), compression (this is entirely optional), and elevation (not crucial for this part of the body).

Arthritis psoriásica

Psoriasis is a skin disease that causes spots with itching or pain in thick, red skin with silvery scales.

Some psoriasis people also develop a form of arthritis (inflammation and swelling of the joints) called psoriatic arthritis.

You must visit your primary care doctor to control this disease since there are many treatment options.

A treatment plan will often consist of therapy (physical, occupational, massage), patient education, exercise and rest, devices to protect the joints, medications, and surgery.


Fibromyalgia is a disorder that causes widespread pain, sensitivity, and fatigue. Fibromyalgia is treated symptomatically. Medication, therapy, and stress reduction can reduce symptoms.

Diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis is calcification or hardening of the ligaments in the areas attached to the spine.

It is assumed that the ligaments are flexible so that diffuse idiopathic skeletal hyperostosis can cause symptoms such as pain, stiffness, and restricted movement.

You should visit your primary care physician, who can confirm the diagnosis with X-rays and locate the problem in specific areas of your spine. This disease is treated with medications for pain, physiotherapy, and, in exceptional cases, surgery.

Osteoma osteoid

An osteoid osteoma is a benign (noncancerous) tumor that usually develops in the long bones of the legs. The thigh bone (femur) is affected more frequently, although the bones of the hand or spine may have an occasional involvement.

This condition is found more frequently in young people. You must visit your primary care doctor. This condition requires various treatments, such as minimally invasive surgery to kill or scrape the tumor.

Neuralgic amyotrophy

Hereditary neuralgic amyotrophy is characterized by episodes of severe pain and muscle wasting (amyotrophy) in one or both shoulders and arms.

Neuralgic pain is felt along the path of one or more nerves and often has no apparent physical cause. The network of nerves involved in hereditary neuralgic amyotrophy, called the brachial plexus, controls movement and sensation in the shoulders and arms.

You should visit your primary care doctor, who will probably coordinate care with a nerve specialist (neurologist). Treatment for this condition involves pain management with medication and physical therapy.

Muscle tension and injuries

The muscles of the neck, shoulders, and back support the upper body and head and support stress due to worry and poor posture.

These muscles can cause pain in the upper right back after injuries, such as a muscle strain or bruise from a car accident or fall.

Excessive work or recreational activities, such as painting or playing racquet sports, could also be the culprit, especially for right-handed people.

Even long periods of computer work using a mouse with the right or left hand can stress the upper back muscles.

The activation points of the upper back (irritable areas in the muscles that can feel like tiny knots) can also cause pain in this area, as well as in the shoulder.

Bone conditions

The bones of the neck and shoulders include:

  • The vertebrae or bones of the back.
  • The clavicle.
  • The scapula or scapula.
  • The ribs.
  • The humerus, or upper arm.

Injuries to these bones that cause bruising or fractures can cause pain in the upper right part of the back, as can arthritis in the joints between these bones.

Fractures from osteoporosis and cancers that have started or have spread to these bones, most often a tumor of the breast, lung, prostate, thyroid, and kidney, can also cause pain in this area.

Lung conditions

Pain in the upper back may be due to problems affecting the lungs, especially if the right lung is involved.

Common causes include pneumonia and pleurisy, which refers to infection or inflammation of the thin layer of tissue surrounding the lung and lines of the chest cavity.

The accumulation of fluid around the lung, known as a pleural effusion, can sometimes cause pain in the upper back. Cancer in the lung, whether it arises there or spreads from another organ, is possible.

Sudden pain accompanied by difficulty breathing may indicate a blood clot in the lung, known as pulmonary embolism.

Other causes

Problems related to the gallbladder, liver, intestines, stomach, esophagus, appendix, kidney, fallopian tubes, and the ovary can sometimes cause referred pain in the upper back.

Particularly concerning diseases of the liver and gall bladder and stomach or intestinal ulcers, the pain referred to the upper back and shoulder is usually the result of irritation of the diaphragm. This muscle separates the chest and the abdominal cavities.

Other specific conditions that affect the internal organs that can sometimes cause pain in the upper right part of the back, with or without pain near the affected organ, include:

  • Kidney infection
  • Kidney stones
  • Appendicitis .
  • Rupture or constriction of the esophagus.
  • Ovarian cyst or torsion of the ovary.
  • Condition of the ovarian tubes.
  • Pregnancy in the ovarian lines is known as tubal or ectopic pregnancy.

Warnings and precautions

Consult your doctor as soon as possible if you experience persistent, severe, or worsening pain in your upper right back.

Seek urgent medical attention if your pain is related to an injury or accident or accompanied by warning signs and symptoms, such as difficulty breathing or difficulty coughing, sudden coughing up blood, vomiting, blood, difficulty swallowing, or feeling of choking.