Why Does My Middle and Upper Back Hurt?

Medically Reviewed by Tyler Wheeler, MD on November 17, 2022
3 min read

Your upper and middle back area is less prone to trouble than your lower back. That’s because it doesn’t bear as much of the load of your body’s weight and work as your lower back does.

But this area, which runs from the base of your neck to the bottom of your rib cage, can still be a source of pain.

You have 12 vertebrae in your upper and middle back. You may hear a doctor refer to them as T1 through T12. The T stands for “thoracic.”

Between the vertebrae are spongy discs. You might think of them as shock absorbers for your body. They cushion the bones when you move around. Ligaments and muscles hold the spine together. The entire area is called the thoracic spine.

It works with your ribs to keep your body stable and protect vital organs such as your heart and lungs.

Pain in your upper and middle back may be described as:

  • Aching
  • Stiffness
  • Sharp
  • Burning

There are any number of reasons your upper and middle back can hurt. Strain or injury to the muscles and ligaments that support your spine is sometimes the problem. This can come from overuse.

You might also have poor posture. When you sit, try to keep your shoulders back. When you stand, try to keep your back as straight as possible and your weight evenly placed on your feet.

Other possible causes include:

  • A pinched nerve. This could happen in your spine near your ribs.
  • A fractured vertebra
  • A herniated disc. When the area around the disc is damaged, the cushioning material pushes out between your vertebrae and can press on spinal nerves.
  • Osteoarthritis. Cartilage that protects your bones might wear down, leading to pain. Bone spurs can press on spinal nerves. This condition can hit many parts of the body, but the spine is among the most commonly affected.
  • Myofascial pain syndrome. This is an ongoing (or “chronic”) pain disorder. It’s usually triggered after a muscle has contracted over and over. Sometimes, it’s related to your job or a hobby that requires the same repeated motion.
  • Gallbladder issues.Gallstones can cause pain between your shoulder blades or around your right shoulder.

Several factors can increase your chances of having upper and middle back pain. Among them:

  • Age.Back pain starts for most people in their 30s or 40s, and it’s more common the older you get.
  • Being out of shape. The stronger the muscles in your back, shoulder, and abdomen, the lower your chance of injury.
  • Weight. If you carry extra pounds, you put more strain on your back.
  • Underlying conditions. Diseases such as arthritis and cancer can cause back pain.
  • Smoking. Smoker’s cough can strain your back. And if you smoke, you may be slower to heal, which can make your back pain last longer.

If you’re like most people with upper and middle back pain, you’ll be able to manage your symptoms at home. Over-the-counter pain relievers, heat, or ice may be enough to ease your condition.

You should call your doctor, though, if your pain becomes too intense or starts to keep you away from your daily activities.

Certain symptoms require fast attention. They include:

  • Losing control of your bowels or bladder.
  • Fever along with pain.
  • Pain that starts after a fall, an accident, or a sports injury.