11 Signs Your Upper Back Pain Is Serious Trouble
Updated: Nov. 25, 2020
Backaches can be an annoyance—or they can sideline you for days. Here's how to sort out if your upper back pain is run-of-the-mill or an emergency.
It may be your desk job
Slouch much? “Upper back pain is most commonly from poor posture,” says Irene Tien, MD, emergency medicine physician with the Rowe Telemedicine Network. Sitting and staring at a computer “shortens chest muscles and pulls on the muscles in the upper back. A lot of people get a muscle spasm between the shoulder blades as a result,” she explains.
It could also be stress
Along with sub-par posture, strain in the muscles around the neck and shoulders or between the shoulder blades can be multi-factorial, says Kaliq Chang, MD, an interventional pain management specialist at the Atlantic Spine Center in West Orange, New Jersey. Most notably: stress, strenuous exercise, and sleeping with your neck in a weird position. Do these back stretches daily to help prevent strain and pain.
What you can do
Often, you can stay home. “A typical episode of muscle strain usually lasts only a few days,” explains Dr. Chang. Staying comfortable during this time is key. He suggests resting, icing, and taking anti-inflammatory medications like ibuprofen or naproxen. Here are 8 reasons for your back pain, and what you can do about it.
When to go to the doctor
You can’t always assume the discomfort is no big deal. “If pain lingers for more than a few days or requires regular pain medications,” you should be evaluated by your physician, says Leda Ghannad, MD, assistant professor of orthopedic surgery and physical medicine and rehabilitation at Rush University Medical Center. Another sign: if the pain limits your abilities in your day-to-day life, like you have to call off work to stay in bed. Following are signs you need to get medical help, pronto. Your doctor can also help you determine what type of back pain you have.
The ache won’t go away
You’ve tried the DIY treatments, gotten massages, and maybe even bought a new mattress. If your upper back is persistently hurting, it may—very rarely—be a sign of a lung tumor. The Canadian Cancer Society points out that advanced lung cancer may contribute to bone pain. Weight loss, chest pain, and weakness are also signs of lung cancer.
You were in a car accident
If you’re able to walk away from a rear end crash and feel OK, you may decide not to get checked out by a doctor. However, whiplash—a violent backward-and-forward jerk of the head—can create “tears and inflammation of the muscles and ligaments in the neck and upper back,” explains Dr. Chang. See your doctor if you suspect whiplash, especially if you have other symptoms like fatigue, dizziness, and pain in your neck. If it is whiplash, here are some exercises you can do that help ease back pain.
You feel pain in the side, too
Anyone who’s had a kidney stone knows they’re quite agonizing—and they may cause upper back pain, says Dr. Ghannad. It’s unlikely that this is the only symptom you’ll notice though. You may also feel severe pain in your side and back below your ribs, the Mayo Clinic notes. Discomfort while peeing or red- or brown-hued urine may be other clues. The best advice? “If pain is severe and persistent, it’s a good idea to be evaluated by a physician,” says Ghannad. And here’s how long it usually takes to pass a kidney stone.
You have a fever
The flu may be going around—but this isn’t any old illness. In certain instances, severe back pain with an accompanying fever or numbness or tingling in your arms can be from a spinal infection, points out Dr. Tien. Some risk factors are if you’re immunosuppressed, have cancer or diabetes, or are obese. If your doc thinks you may have a spinal infection, they may order an X-rays, CT, or MRI scan to help make the diagnosis. Antibiotic or antifungal medications can treat the issue. Here’s what to know about acupuncture for back pain.
The pain is searing through your chest, too
Numbness or weakness in your arms can be one sign of a stroke—or it may also be an indication of a tear in the wall of the aorta, the largest blood vessel in your body that runs in the back of your chest, says Dr. Tien. She adds that you’re especially at risk if you have uncontrolled high blood pressure over a long period of time. “This can cause a tearing mid-chest and/or back pain,” she describes. Just like a stroke, this is an emergency that requires immediate medical care. Here are 7 more signs of a stroke you might be ignoring.
You’re really fatigued
The myth of the heart attack victim clutching their chest and collapsing has long been busted. It pays to listen up to subtler signs like nausea, shortness of breath, extreme fatigue, and back pain, says Dr. Tien.
Your legs are weak
It’s time to think about a possible slipped disc (also called a herniated disc), which can happen if you lift something heavy using your back instead of your legs. If you feel upper back pain along with numbness or weakness in your arms or legs, it may be a sign of a neurologic injury from a slipped disc, says Dr. Chang. Your doc can make the diagnosis with a physical exam.
Pain moves from your chest to your back
One potential cause of back pain is a condition called costochondritis, an inflammation of the cartilage connecting your ribs to your breastbone. While lifting heavy items, respiratory infections, and chest injuries can cause it, often the source of the pain is unclear. You may feel pain that travels from your chest to your back. Definitely get checked out by your doctor, it often goes away without any treatment. You should also watch out for these 7 types of leg pain.
A deep breath hurts
Take a deep breath: how does that feel? If “extremely painful” is your answer, get checked out. One emergency-worthy cause is a pulmonary embolism, says Dr. Tien. “Blood clots can break off from a deep vein in the leg or arm and travel to the lung, wedging in blood vessels, causing poor blood flow, inflammation, and death of lung tissue,” she explains. If your back pain gets worse with a deep breath, you’re short of breath, you’re coughing up blood, or you feel faint, call 911.
You’re short of breath
Rarely, upper back pain may be due to a punctured lung, which can be caused by an injury. While it is less likely to be the cause of your discomfort, a punctured lung is something you need to know the signs of so you can take the right action. “If the pain is accompanied by shortness of breath or severe pain taking a deep breath, seek urgent medical care,” advises Dr. Chang. If it’s nothing serious, then you can try these lung exercises to build up lung power.
Pain intensifies when you move
You had a recent fall, but you didn’t think your back would hurt this much! “If you had a traumatic injury, like a heavy object lands on your back or you slip on the ice and fall with your back striking the edge of a step, you can break a vertebral bone or a rib,” notes Dr. Tien. (Depending on where you broke it you may feel upper left back pain, or it may appear on your right side.) The pain can be moderate to severe, but it will get worse when you move. Talk to your doctor, especially after any bad injury. And read up on some strategies to manage your pain effectively.
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